Individual
JUANITA FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3934 TYNEWICK DR, SILVER SPRING, MD 20906-2666
(202) 763-9124
Mailing address
5820 YORK RD STE 201, BALTIMORE, MD 21212-3620
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
27471
MD
104100000X
Social Worker
LG200002703
DC
1041C0700X
Clinical Social Worker
Primary
27471
MD
1041C0700X
Clinical Social Worker
LC200003459
DC
Other
Enumeration date
08/20/2024
Last updated
05/05/2025
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