Individual
CHERYL FORTENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1154 ASPEN RD, HIGHLANDVILLE, MO 65669-8057
(417) 693-0112
Mailing address
1154 ASPEN RD, HIGHLANDVILLE, MO 65669-8057
(417) 693-0112
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003705
MO
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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