Provider Demographics
NPI:1447508288
Name:FONTES, KRISTIANNA R (LSW)
Entity type:Individual
Prefix:MS
First Name:KRISTIANNA
Middle Name:R
Last Name:FONTES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SUMMER ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3469
Mailing Address - Country:US
Mailing Address - Phone:508-965-4231
Mailing Address - Fax:508-884-2476
Practice Address - Street 1:35 SUMMER ST
Practice Address - Street 2:SUITE 202
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3469
Practice Address - Country:US
Practice Address - Phone:508-965-4231
Practice Address - Fax:508-884-2476
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker