Individual
KAIESHA FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED
Contact information
Practice address
11240 WAPLES MILL RD STE 101, FAIRFAX, VA 22030-6078
(703) 237-2219
Mailing address
3020 PARK PL NW, WASHINGTON, DC 20001-2918
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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