Individual
SHANNON LYN FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
500 CUMMINGS CTR, SUITE 3850, BEVERLY, MA 01915-6142
(978) 232-0332
Mailing address
3 WATSON ST, #1, SOMERVILLE, MA 02144-1528
(401) 474-3679
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
8341
MA
Other
Enumeration date
05/21/2007
Last updated
07/02/2008
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