Individual
JESSICA FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
1317 JAMESTOWN RD, SUITE 102-B, WILLIAMSBURG, VA 23185-3364
(205) 239-4448
Mailing address
177 BARLOW RD, WILLIAMSBURG, VA 23188-2227
(205) 239-4448
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4204
AL
Other
Enumeration date
10/05/2008
Last updated
10/18/2011
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