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Individual

SHARON DELEE FORTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPE-I

Contact information

Practice address
8835 DENNETTE RD, JACKSONVILLE, AR 72076-8650
(501) 500-1389
(949) 577-4838
Mailing address
8835 DENNETTE RD, JACKSONVILLE, AR 72076-8650
(501) 500-1389
(949) 577-4838

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12-02EI
AR
102L00000X
Psychoanalyst
Primary
12-02EI
AR

Other

Enumeration date
10/04/2007
Last updated
10/19/2023
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