John E Fontaine in Jackson - Clinical Child & Adolescent
John E Fontaine - NPI 1093818064
John E Fontaine is a Clinical Child & Adolescent in Jackson, Mississippi. John E Fontaine practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for John E Fontaine is 1093818064. The last update date is 2007-07-08.
John E Fontaine's current location address is 1855 Crane Ridge Dr Ste A, Jackson, Mississippi. You can contact this provider via phone number 6019828700 and fax number 6013663906. The mailing address for John E Fontaine is 1855 Crane Ridge Dr Ste A, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John E Fontaine |
|---|---|
| Address | 1855 Crane Ridge Dr Ste A, Jackson, Mississippi |
| Phone Number | 6019828700 |
| Fax Number | 6013663906 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1093818064 |
|---|---|
| Provider Enumeration Date | 2006-09-06 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1855 Crane Ridge Dr Ste A |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392164944 |
| Phone Number | 6019828700 |
| Fax Number | 6013663906 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | 30429 |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 11417 | MS | -- |
Post Comment/ Review Below
What is the John E Fontaine's 1093818064?
The John E Fontaine's NPI (National Provider Identifier) Number is 1093818064. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where John E Fontaine is geographically located?
The John E Fontaine is physically situated at the following location: 1855 Crane Ridge Dr Ste A, Jackson, MS, 392164944.
What is John E Fontaine's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The John E Fontaine's specialized field of practice is Clinical Child & Adolescent, and the corresponding taxonomy code that categorizes this area of specialization is 103Tc2200X.
When did John E Fontaine receive its 1093818064 assignment?
The John E Fontaine was assigned its 1093818064 on 2006-09-06, which is the date when this unique identifier was issued to the organization.
When was the information related to John E Fontaine most recently updated or refreshed?
The details pertaining to the John E Fontaine, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
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