Individual
AMANDA DESTEFANO FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, MSW
Contact information
Practice address
366 MASSACHUSETTS AVE, SUITE 303, ARLINGTON, MA 02474-6733
(617) 680-5724
Mailing address
366 MASSACHUSETTS AVE, SUITE 303, ARLINGTON, MA 02474-6733
(617) 680-5724
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115429
MA
Other
Enumeration date
03/26/2010
Last updated
11/05/2012
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