Individual
MR. THOMAS JK FONTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,LMHC, ADAC
Contact information
Practice address
5 WOODBINE ST, SOUTH BURLINGTON, VT 05403
(802) 862-2390
Mailing address
5 WOODBINE ST, SOUTH BURLINGTON, VT 05403-6622
(802) 862-2390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0053213
VT
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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