| NPI | 1689109712 |
|---|---|
| Former Name | KARREN FONTENOT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 64056) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW007650) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2021-08-19 |