Individual
MR. MICHAEL FONTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
13 FRESH MEADOW RD, EASTON, CT 06612-2215
(203) 259-8998
Mailing address
13 FRESH MEADOW RD, EASTON, CT 06612-2215
(203) 259-8998
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
001013
CT
106H00000X
Marriage & Family Therapist
Primary
CT 001013
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270023827
TAX ID
CT
Enumeration date
01/17/2007
Last updated
09/03/2019
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