Individual
MS. DEBRA LYNN FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W. L.C.S.W.
Contact information
Practice address
5225 CORNWALL ESTATES DR, SAINT LOUIS, MO 63129-1543
(314) 646-9970
Mailing address
5225 CORNWALL ESTATES DR, SAINT LOUIS, MO 63129-1543
(314) 646-9970
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2000163664
MO
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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