Individual
DR. LAUREN GAY FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3453 PELHAM RD STE 107, GREENVILLE, SC 29615-7400
(864) 800-9353
Mailing address
120 TINDAL AVE, GREENVILLE, SC 29605-2839
(706) 207-3511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1558
SC
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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