Individual
HEATHER FOUNTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1070 N CURTIS RD, BOISE, ID 83706-1238
(208) 392-1317
Mailing address
1070 N CURTIS RD, BOISE, ID 83706-1238
(208) 392-1317
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-45344
ID
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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