Individual
JENNIFER MARIE FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC, LMSW
Contact information
Practice address
5635 W ROOSEVELT RD, CICERO, IL 60804-1230
(708) 652-6500
Mailing address
5635 W ROOSEVELT RD, CICERO, IL 60804-1230
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31246
IL
Other
Enumeration date
03/18/2016
Last updated
05/04/2016
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