Individual
GABRIEL FONTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5312 RIO BRAVO DR STE 10, SANTA TERESA, NM 88008-9210
(575) 915-1338
(575) 915-1819
Mailing address
9816 BOMARC ST, EL PASO, TX 79924-4904
(915) 503-3052
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
02/17/2025
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