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1609407832
ELIZABETH FOUNTAIN
WASILLA, AK
NPI
1609407832
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-01-27
Last Update Date
2020-01-27
Business Address
ELIZABETH FOUNTAIN
7010 E BOGARD RD
WASILLA, AK 99654-4711
Phone number: 907-373-4732
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Mailing Address
ELIZABETH FOUNTAIN
PO BOX 876741
WASILLA, AK 99687-6741
Phone number:
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