Individual
HEATHER LYNN FORNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T., C.C.T.
Contact information
Practice address
146 8TH AVE N, SAFETY HARBOR, FL 34695-3543
(727) 417-0667
Mailing address
2913 FAIRFIELD CT, DUNEDIN, FL 34698-9634
(612) 616-9410
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MM41392
FL
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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