Individual
ELISSIA FORTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
4551 ROUTE 42 STE 5, BLACKWOOD, NJ 08012-1751
(856) 271-4490
Mailing address
455 PENN BLVD, WOODBURY, NJ 08096-2821
(856) 271-4490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL06845000
NJ
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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