Individual
CHRISTINA FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
402 CEDAR CREEK DR, VAN BUREN, AR 72956-6518
(479) 459-3111
Mailing address
402 CEDAR CREEK DR, VAN BUREN, AR 72956-6518
(479) 459-3111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1570
AR
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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