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Individual

MARISA FOUNTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
333 GLEN ST, GLENS FALLS, NY 12801-3666
(518) 760-3376
Mailing address
50 OAK TREE CIR, QUEENSBURY, NY 12804-2170
(518) 760-3376

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
08/02/2024
Last updated
08/02/2024
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