Individual
MADELINE FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3 FLAGG PL, SUITE A3, LAFAYETTE, LA 70508-7003
(337) 857-6833
Mailing address
107 WILD ROSE LN, YOUNGSVILLE, LA 70592-5381
(337) 857-6833
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
891
LA
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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