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General NPI Number Information
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NPI Number | 1659190247
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Entity Type | Organization
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Legal Business Name | FORTITUDINE HEALTH
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 3785 HARRISON BLVD STE 4
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City | OGDEN
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State | UT
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Zip | 84403
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Country | US
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Telephone | 801-686-8488
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Fax | 951-269-4447
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Provider Business Mailing Address
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Address Line | 3785 HARRISON BLVD STE 4
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City | OGDEN
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State | UT
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Zip | 84403-2072
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CLARISSA GOSNEY
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Credential | PSYD
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Telephone | 619-800-3811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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