Individual
MISS JESSIE LYNN FONTENAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
765 ALLENS AVE, PROVIDENCE, RI 02905-5443
(401) 432-6800
Mailing address
540 COLWELL RD, HARRISVILLE, RI 02830-1861
(401) 678-6586
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT02015
RI
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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