Individual
GRETA M FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7932 SUMMA AVE STE B2, BATON ROUGE, LA 70809-3736
(225) 349-7171
Mailing address
4805 SUMMA CT, BATON ROUGE, LA 70809-3714
(337) 580-6898
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
012170280
LA
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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