KELLY FOUNTAIN M.S. L.P.T. L.L.C. NPI 1154714384

NPI Information

KELLY FOUNTAIN, M.S., L.P.T., L.L.C. is a counselor in Mobile, AL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. KELLY FOUNTAIN, M.S., L.P.T., L.L.C. NPI is 1154714384. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2864 DAUPHIN ST
SUITE A
MOBILE, AL
ZIP 36606-479
Phone: (251) 470-7607

The provider's authorized official is Kelly Fountain .
The authorized official title is Owner and has the following contact phone number (251) 470-7607.

The enumeration date for this NPI number is 3/12/2015 and was last updated on 3/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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