Individual
KAATA FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 DILIGENCE DR STE 102, NEWPORT NEWS, VA 23606-4211
(254) 249-6530
Mailing address
162 STILLWELL ST UNIT D, FORT EUSTIS, VA 23604-0656
(706) 566-5744
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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