Individual
VICKIE FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
806 N 31ST ST, SUITE B, MONROE, LA 71201-3900
(318) 737-7794
Mailing address
806 N 31ST ST, SUITE B, MONROE, LA 71201-3900
(318) 737-7794
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5515
LA
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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