Individual
MICHELE FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
153 HAZARD AVE, ENFIELD, CT 06082-4592
(860) 253-5020
(860) 253-5030
Mailing address
153 HAZARD AVE, ENFIELD, CT 06082-4592
(860) 253-5020
(860) 253-5030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000807
CT
Other
Enumeration date
06/13/2007
Last updated
03/16/2012
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