MICHAEL FORTUNE

LIBERTY, TX
NPI1104298280
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX  12037)
Enumeration Date2015-10-28
Last Update Date2015-10-28
Business Address
-- MICHAEL FORTUNE
2800 BEAUMONT AVE # 1
LIBERTY, TX 77575-5126
Phone number: 936-253-1077
Mailing Address
-- MICHAEL FORTUNE
2800 BEAUMONT AVE # 1
LIBERTY, TX 77575-5126
Phone number: 936-253-1077
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