Individual
DR. SUE ELLEN LAFOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6901 N CHARLES ST, TOWSON, MD 21204-3780
(410) 812-5839
Mailing address
5071 BLACKSMITH DR, COLUMBIA, MD 21044-1304
(410) 812-5839
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
03005
MD
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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