| Jodi Fortner Llc | |
|
1323 Jasper Ln Washington MO 63090-4148 | |
| (636) 667-9292 | |
| Not Available |
| Full Name | Jodi Fortner Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1323 Jasper Ln, Washington, Missouri |
| Authorized Official Name and Position | Jodi Lin Fortner (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 6366679292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jodi Fortner Llc 1323 Jasper Ln Washington MO 63090-4148 Ph: (636) 667-9292 | Jodi Fortner Llc 1323 Jasper Ln Washington MO 63090-4148 Ph: (636) 667-9292 |
| NPI Number | 1275974842 |
|---|---|
| Provider Enumeration Date | 07/11/2013 |
| Last Update Date | 07/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275974842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2010013715 (Missouri) | Primary |
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