Organization
FELICIA FORTNER
Active
Parent organization
FELICIA FORTNER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FELICIA FORTNER
Authorized official
FELICIA FORTNER (THERAPIST)
(972) 375-8268
Entity
Organization
Contact information
Practice address
1012 SAN JACINTO DR, IRVING, TX 75063-8221
(972) 375-8268
Mailing address
1012 SAN JACINTO DR, IRVING, TX 75063-8221
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
67702
TX
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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