Provider Demographics
NPI:1134471568
Name:PAINTER, ANTOINETTE MARIE
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:MARIE
Last Name:PAINTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 CARSON AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6905
Mailing Address - Country:US
Mailing Address - Phone:559-341-5530
Mailing Address - Fax:
Practice Address - Street 1:5168 N BLYTHE AVE
Practice Address - Street 2:101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6477
Practice Address - Country:US
Practice Address - Phone:559-341-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor