# AMANDA L FONTAINE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1679503924
- **Gender:** F
- **Credential:** LMFT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MFT00098 | RI | Yes |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 01/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1023290 | NEIGHBORHOOD HEALTH OF RI | RI |
| 01 | — | 27655-1 | BLUE CROSS | RI |
| 01 | — | 411932 | BLUE CHIP | RI |
| 05 | — | AO54832 | — | RI |
| 05 | — | FM49368 | — | RI |