| Doctor Name: | MRS. MICHELLE RENEE FONTENOT |
| NPI Number: | 1013298991 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC |
| License Number: | |
| Business Practice Address: | 748 Bayou Pines East Dr Ste B Lake Charles, LA - 706017184 |
| Business Phone Number: | 3372748017 |
| Business Fax Number: | 3372141836 |
| Mailing Address: | 748 Bayou Pines East Dr, Ste B LAKE CHARLES |
| State: | LA |
| Postal Code: | 706017184 |
| Phone Number: | 3372748017 |
| Fax Number: | 3372141836 |
| NPI Enumeration Date: | 09/06/2011 |
| NPI Last Update Date: | 11/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |