Individual
STACEY M FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1101 JOHNSON AVE, MYRTLE BEACH, SC 29577-1893
(843) 477-0177
Mailing address
1101 JOHNSON AVE, MYRTLE BEACH, SC 29577-1893
(843) 477-0711
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5553
SC
Other
Enumeration date
07/23/2018
Last updated
12/03/2018
About Stedi
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