Fontaine, Joan Lee
Fontaine, Joan Lee is an individual health care provider with primary practice located at 3500 Baltimore Ave , Pueblo CO 81008-1543. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Fontaine, Joan Lee can be contacted via phone (719) 545-1181.Contact Information
Primary practice address
3500 Baltimore Ave
Pueblo CO 81008-1543
Phone: (719) 545-1181
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 4236 | Colorado |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 1418 | Colorado |
Profile Details
| NPI number | 1891850053 |
|---|---|
| LBN Legal business name | Fontaine, Joan Lee |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Dec 3rd, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891850053 | NPPES |
| Colorado | Other | 4236 | CAC III |
| Colorado | Other | 1418 | CAC III |
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