JACQUELINE FOUNTAIN

WINSLOW, AZ
NPI1982596243
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LIAC-155391)
Enumeration Date2025-07-19
Last Update Date2025-09-04
Business Address
JACQUELINE FOUNTAIN LAAC
110 E SECOND ST
WINSLOW, AZ 86047-3704
Phone number: 602-989-3276
Mailing Address
JACQUELINE FOUNTAIN LAAC
110 E SECOND ST
WINSLOW, AZ 86047-3704
Phone number: 928-358-9370
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