Latisha Louise Fontana, M.ED. L.P.C.

NPI #1902901770 in Grover, Missouri

Provider Information

NPI Number: 1902901770
Entity Type: Individual
Name: Latisha Louise Fontana, M.ED. L.P.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: M.ED. L.P.C.
Enumeration Date: Sep 14, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2646 HIGHWAY 109
Address 2: SUITE 200
City: Grover
State: Missouri
ZIP Code: 63040-1162
Phone: (636) 458-0002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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