Individual
MRS. JACQUELINE FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
24 LONGHORN DR, WEST HENRIETTA, NY 14586-9739
(585) 410-9775
Mailing address
24 LONGHORN DR, WEST HENRIETTA, NY 14586-9739
(585) 410-9775
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
341101060398E
NY
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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