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1518227032
STACY SIMS FORTENBERRY
HATTIESBURG, MS
NPI
1518227032
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: MS 0669)
Enumeration Date
2012-05-17
Last Update Date
2012-05-17
Business Address
MR. STACY SIMS FORTENBERRY LPC
5 ORLEANS DR SUITE 2
HATTIESBURG, MS 39402-8675
Phone number: 601-550-7383
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Mailing Address
MR. STACY SIMS FORTENBERRY LPC
22 BLOSSOM CIR
PURVIS, MS 39475-3585
Phone number: 601-550-7383
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