Individual
ELIZABETH FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3100 DUNDEE RD STE 704, NORTHBROOK, IL 60062-2442
(847) 498-5437
(847) 498-5438
Mailing address
3100 DUNDEE RD STE 704, NORTHBROOK, IL 60062-2442
(847) 498-5437
(312) 893-2118
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16419
IL
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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