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1063902849
REBECCA FOUNTAIN
PADUCAH, KY
NPI
1063902849
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: KY 174287)
Enumeration Date
2018-05-16
Last Update Date
2018-05-16
Business Address
REBECCA FOUNTAIN LPA
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number: 270-442-9767
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Mailing Address
REBECCA FOUNTAIN LPA
1640 JEFFERSON ST APT 203
PADUCAH, KY 42001-2721
Phone number: 270-559-9547
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