Tavia I Fontenot
NPI #1700616463 in Canyon Lake, California
Provider Information
- NPI Number
- 1700616463
- Entity Type
- Individual
- Name
- Tavia I Fontenot
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Aug 6, 2024
- Last Updated
- Aug 6, 2024
Practice Location
- Address
- 30039 SWAN POINT DR
- City
- Canyon Lake
- State
- California
- ZIP Code
- 92587-7407
- Phone
- (951) 796-3840
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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