Individual
JENNIFER STAM FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
606 S HALLIBURTON ST, KIRKSVILLE, MO 63501-3712
(660) 785-7551
Mailing address
807 GREENWAY DR, KIRKSVILLE, MO 63501-2027
(660) 341-2686
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2024007670
MO
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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