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Individual

SIENNA FONTAINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, LADC, MSW

Contact information

Practice address
1 MILL ST STE 324, BURLINGTON, VT 05401-1554
(802) 318-2993
Mailing address
1 MILL ST STE 324, BURLINGTON, VT 05401-1554
(802) 318-2993

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151.0134047
VT
1041C0700X
Clinical Social Worker
Primary
089-0130118
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1031471
VT
Enumeration date
09/12/2017
Last updated
02/07/2024
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