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Individual

MR. RANDY FONTENOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
5329 DIJON DRIVE, SUITE 105, BATON ROUGE, LA 70808
(225) 276-8428
Mailing address
5329 DIJON DRIVE, SUITE 105, BATON ROUGE, LA 70808-8721
(225) 276-8428

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2810
LA

Other

Enumeration date
11/20/2009
Last updated
06/23/2010
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