Fontes, Martice

Fontes, Martice is an individual health care provider with primary practice located at 2271 Overland Ave Ste 5 , Burley ID 83318-2957. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Fontes, Martice can be contacted via phone (208) 678-9114.

Contact Information

Primary practice address
2271 Overland Ave Ste 5 Burley ID 83318-2957
Fax: (208) 678-8989
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LAMFT-5182 Idaho

Profile Details

NPI number 1831518976
LBN Legal business name Fontes, Martice
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2014
Last updated Apr 15th, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831518976 NPPES
Idaho MEDICAID 1376561274

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