| NPI | 1629691225 |
|---|---|
| Former Name | JULIANNE FOUNTAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11007968) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2024-06-26 |