Individual
CORYNN NICOLE FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 456-7575
Mailing address
1717 COOPER POINT RD SW APT E29, OLYMPIA, WA 98502-5756
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP.CP.70071323
WA
Other
Enumeration date
03/17/2026
Last updated
03/17/2026
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