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Individual

MRS. SONYA LEA FONTAINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3500 S BOULEVARD, BLDG B SUITE 12B, EDMOND, OK 73013-5486
(405) 206-3185
Mailing address
3230 EVERETT DR, EDMOND, OK 73013-7441
(405) 206-3185

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1458
OK

Other

Enumeration date
09/05/2012
Last updated
09/05/2012
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