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Contact Information

MARY N FONTENOT
1324 ROSETTA ST
LAKE CHARLES, LA70607-1932
 Phone: 337-912-8617
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vehicle Modifications

171WV0202X
Indicates primary specialty

NPI Profile & details for MARY N FONTENOT · (Female)

NPI Number 1346744042
Status Active
Credentials
Entity Individual
Enumeration date 03/19/2018
Last updated 03/19/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 008907424
  • LA Medicaid 882717925
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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