Doctor Name: | MS. SUSAN L FORTNEY-HARLAN |
NPI Number: | 1043201791 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW LISW |
License Number: | I0008257 |
Business Practice Address: | 10 N Locust St Suite B3 Oxford, OH - 450561192 |
Business Phone Number: | 5135231706 |
Business Fax Number: | |
Mailing Address: | 262 Ryan Dr, OXFORD |
State: | OH |
Postal Code: | 450568919 |
Phone Number: | 5135233468 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I0008257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |