| Fortitude Llc | |
|
777 E Wheatland Rd Ste 104 Duncanville TX 75116-4918 | |
| (214) 546-4746 | |
| (214) 919-1791 |
| Full Name | Fortitude Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 777 E Wheatland Rd Ste 104, Duncanville, Texas |
| Authorized Official Name and Position | Nelina Renee Moffett (OWNER/COUNSELOR) |
| Authorized Official Contact | 2145464746 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortitude Llc 777 E Wheatland Rd Ste 104 Duncanville TX 75116-4918 Ph: (214) 546-4746 | Fortitude Llc 777 E Wheatland Rd Ste 104 Duncanville TX 75116-4918 Ph: (214) 546-4746 |
| NPI Number | 1417602392 |
|---|---|
| Provider Enumeration Date | 02/18/2022 |
| Last Update Date | 02/18/2022 |
| Certification Date | 02/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417602392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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