Individual
AUSTIN MICHAL FONTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
(208) 524-7335
Mailing address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
(208) 524-7335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-43547
ID
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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