CANDICE FOUNTAIN

JACKSON, MS
NPI1629150818
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225XR0403X Occupational Therapist, Driving and Community Mobility
(Licence: MS  OT2019)
Enumeration Date2006-10-19
Last Update Date2007-07-08
Business Address
-- CANDICE FOUNTAIN
2475 LAKELAND DR STE A
JACKSON, MS 39232-9505
Phone number: 601-636-6019
Mailing Address
-- CANDICE FOUNTAIN
1054 HIGHLAND COVE PL
RIDGELAND, MS 39157-1523
Phone number: 601-636-6019
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