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1790337459
SHANISE FONVILLE
WESTAMPTON, NJ
NPI
1790337459
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-07-12
Last Update Date
2019-07-12
Business Address
SHANISE FONVILLE
770 WOODLANE RD
WESTAMPTON, NJ 08060-3804
Phone number: 606-267-5928
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Mailing Address
SHANISE FONVILLE
770 WOODLANE RD
WESTAMPTON, NJ 08060-3804
Phone number: 606-267-5928
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