Individual
FAITH FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3701 LANDSDOWNE DR, ASHLAND, KY 41102-5422
(606) 324-3005
Mailing address
3701 LANDSDOWNE DR, ASHLAND, KY 41102-5422
(606) 324-3005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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