Individual
MR. TERRY B FONTENOT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
939 BAXTER AVE, LOUISVILLE, KY 40204-2046
(502) 456-4773
(502) 456-9472
Mailing address
939 BAXTER AVE, LOUISVILLE, KY 40204-2046
(502) 456-4773
(502) 456-9472
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
035
KY
106H00000X
Marriage & Family Therapist
Primary
0277
KY
Other
Enumeration date
06/24/2005
Last updated
09/11/2025
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