Individual
BRYANNE E FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 HALL AVENUE, SUITE A, MARINETTE, WI 54143
(715) 732-7760
(715) 732-7711
Mailing address
2500 HALL AVENUE, SUITE A, MARINETTE, WI 54143
(715) 732-7760
(715) 732-7711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9013-123
WI
Other
Enumeration date
05/01/2008
Last updated
12/08/2021
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