Individual
BRANDY THELMA FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2823 LEXINGTON AVE N, APT 103, ROSEVILLE, MN 55113-2086
(612) 275-3985
Mailing address
2823 LEXINGTON AVE N, APT 103, ROSEVILLE, MN 55113-2086
(612) 275-3985
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
07/22/2024
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