Individual
SHAWNDELLANA DEWON FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3312 CURTIS DR APT 301, SUITLAND, MD 20746-2653
(202) 609-3816
Mailing address
3312 CURTIS DR APT 301, SUITLAND, MD 20746-2653
(202) 609-3816
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
MT0067063
MD
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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