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NPI Code Detail

MEDICARE: CAROL FONTENOT

MEDICARE: CAROL FONTENOT
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 Worker3317LA

General Provider Information

NPI Number : 1750777256
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL FONTENOT
Provider Business Mailing Address
First Line : PO BOX 6744
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70174-6744
Country : US
Telephone Number : 504-309-7844
Fax Number : 504-309-7845
Provider Business Practice Location Address
First Line : 3324 AUDUBON TRCE
Second Line :
City : JEFFERSON
State : LA
Zip : 70121-1588
Country : US
Telephone Number : 504-834-6771
Fax Number : 504-309-7845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2015
Last Update Date : 04/10/2015

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Directions to “ CAROL FONTENOT ” Practice Location

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