Individual
JILL ELIZABETH FONTANELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Contact information
Practice address
79 MILL ST, MIDDLETOWN, CT 06457-4468
(203) 213-9078
(860) 349-0324
Mailing address
45 SHULER LN, DURHAM, CT 06422-3012
(203) 213-9078
(860) 349-0324
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004382
CT
Other
Enumeration date
12/26/2006
Last updated
03/22/2012
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