Individual
CHEYENNE VARGAS FONTANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6539 THOREAU DR, PORTAGE, IN 46368-0079
(219) 331-5409
Mailing address
6539 THOREAU DR, PORTAGE, IN 46368-0079
(219) 331-5409
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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