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1811147895
MICHELLE FOUNTAIN
SANTA ROSA, CA
NPI
1811147895
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Former Name
MICHELLE NEWTON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 65670)
Enumeration Date
2008-09-25
Last Update Date
2015-03-11
Business Address
-- MICHELLE FOUNTAIN LCSW
1200 COLLEGE AVE
SANTA ROSA, CA 95404-3908
Phone number: 707-568-2300
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Mailing Address
-- MICHELLE FOUNTAIN LCSW
444 TROWBRIDGE ST
SANTA ROSA, CA 95401-5323
Phone number: 707-529-7835
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