Individual
REBECCA ELLEN FANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
367 PINE ST, SPRINGFIELD, MA 01105-1930
(413) 737-1426
Mailing address
37 HARRIS ST, AMHERST, MA 01002-1318
(413) 549-6494
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
8515
MA
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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