Individual
NICOLE FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25700 N. 21ST AVENUE, PHOENIX, AZ 85085
(623) 445-5800
Mailing address
1715 W EAGLE TALON TRL, PHOENIX, AZ 85085-5344
(602) 309-1313
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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