DR. John E Fontaine IV, PH.D.
NPI #1093818064 in Jackson, Mississippi
Provider Information
- NPI Number
- 1093818064
- Entity Type
- Individual
- Name
- DR. John E Fontaine IV, PH.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical Child & Adolescent
- Credential
- PH.D.
- Enumeration Date
- Sep 6, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1855 CRANE RIDGE DR STE A
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39216-4944
- Phone
- (601) 982-8700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent |
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