Individual
MRS. MICHELLE E FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1500 SYCAMORE RD, SUITE 330, MONTOURSVILLE, PA 17754-9303
(570) 322-5051
(570) 322-6788
Mailing address
1500 SYCAMORE RD, SUITE 330, MONTOURSVILLE, PA 17754-9303
(570) 322-5051
(570) 322-6788
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW126880
PA
Other
Enumeration date
07/20/2009
Last updated
07/20/2009
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