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Individual
SIENNA FONTAINE
Active
Individual
SIENNA FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, LADC, MSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151.0134047
VT
1041C0700X
Clinical Social Worker
Primary
089-0130118
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031471
—
VT
Enumeration date
09/12/2017
Last updated
02/07/2024
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