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NPI Code Detail

MEDICARE: MRS. ERIKA FONTANA LISW

MEDICARE: MRS. ERIKA FONTANA LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.1800943OH

General Provider Information

NPI Number : 1972767085
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ERIKA FONTANA LISW
Provider Business Mailing Address
First Line : 6500 POE AVE STE 400
Second Line :
City : DAYTON
State : OH
Zip : 45414-2527
Country : US
Telephone Number : 937-276-3356
Fax Number : 937-276-9514
Provider Business Practice Location Address
First Line : 6500 POE AVE STE 400
Second Line :
City : DAYTON
State : OH
Zip : 45414-2527
Country : US
Telephone Number : 937-276-3356
Fax Number : 937-276-9514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2008
Last Update Date : 10/11/2022

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