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Individual

PATRICIA M FANTONI-SALVADOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
7601 NW 13TH CT, PLANTATION, FL 33322-4705
(206) 257-1061
(206) 257-1061
Mailing address
10002 AURORA AVE N STE 36, SEATTLE, WA 98133-9348
(206) 257-1061
(206) 257-1061

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY5902
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
762864100
FL
Enumeration date
12/02/2005
Last updated
01/13/2012
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