MR. Michael J Fonda, LCPC

NPI #1649312257 in Broadview, Illinois

Provider Information

NPI Number: 1649312257
Entity Type: Individual
Name: MR. Michael J Fonda, LCPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LCPC
Enumeration Date: Feb 12, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1820 S 25TH AVE
City: Broadview
State: Illinois
ZIP Code: 60155-2864
Phone: (708) 338-3806

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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