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Individual

JONATHAN FENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LGPC

Contact information

Practice address
10176 BALTIMORE NATIONAL PIKE STE 110, ELLICOTT CITY, MD 21042-3651
(443) 720-0090
Mailing address
2804 ALDEN RD, PARKVILLE, MD 21234-5625
(847) 736-0637

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP13243
MD
101YM0800X
Mental Health Counselor

Other

Enumeration date
11/07/2016
Last updated
11/21/2022
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