Individual
MICHAEL BRADLEY FONTANESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6611 RIVER PLACE BLVD STE 305, AUSTIN, TX 78730-1163
(714) 272-0816
Mailing address
6611 RIVER PLACE BLVD STE 305, AUSTIN, TX 78730-1163
(714) 272-0816
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-80115
TX
Other
Enumeration date
07/25/2021
Last updated
04/20/2025
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