| NPI | 1891850053 |
|---|---|
| Other Name | JODY LEE FONTAINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 1418) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 4236) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2010-12-03 |