NPI | 1063717908 |
---|---|
Doing Business As | DR. TIM FORTNEY |
Entity Type | Organization |
Authorized Contact | TIMOTHY FORTNEY Psychologist 239-443-0498 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8142) |
Enumeration Date | 2011-01-25 |
Last Update Date | 2011-02-04 |