Individual
TANYA FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GENERAL MOUTON AVE, LAFAYETTE, LA 70501-7826
(337) 298-9688
(337) 363-5079
Mailing address
120 N LIBERTY ST, OPELOUSAS, LA 70570-5232
(337) 849-1095
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN130284
LA
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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