Individual
LEILA CATHERINE FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5130 E MAIN STREET RD STE 2, BATAVIA, NY 14020-3444
(585) 727-7053
Mailing address
5130 E MAIN STREET RD STE 2, BATAVIA, NY 14020-3444
(585) 727-7053
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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