| NPI | 1174889109 |
|---|---|
| Former Name | SUSANNAH JANE FORTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-06-13 |