Individual
ANGELINA BRENDA FONTANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC AAP NCC NBCC
Contact information
Practice address
1629 10TH AVE STE B, COLUMBUS, GA 31901-3520
(706) 256-0442
(706) 317-2669
Mailing address
290 LEE ROAD 309, PHENIX CITY, AL 36870-9180
(706) 888-0710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
232341
GA
Other
Enumeration date
09/13/2008
Last updated
09/05/2011
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