MICHAEL J FONDA

BROADVIEW, IL
NPI1649312257
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: IL  180-001050)
Enumeration Date2007-02-12
Last Update Date2007-07-08
Business Address
Mr. MICHAEL J FONDA LCPC
1820 S 25TH AVE
BROADVIEW, IL 60155-2864
Phone number: 708-338-3806
Mailing Address
Mr. MICHAEL J FONDA LCPC
322 GEORGETOWN AVE
ROMEOVILLE, IL 60446-4113
Phone number: 815-372-6245
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