Individual
JEBADIAH FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
11 LIBERTY ST, WARREN, RI 02885-3009
(207) 852-1175
Mailing address
11 LIBERTY ST, WARREN, RI 02885-3009
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
10/11/2025
Last updated
10/11/2025
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