Doctor Name: | KELLY RAWLS FOUNTAIN |
NPI Number: | 1003148487 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., L.P.T. |
License Number: | 1586 |
Business Practice Address: | 2864 Dauphin St Suite A Mobile, AL - 366062479 |
Business Phone Number: | 2514707607 |
Business Fax Number: | 2514707609 |
Mailing Address: | 2864 Dauphin St, Suite A MOBILE |
State: | AL |
Postal Code: | 366062479 |
Phone Number: | 2514707607 |
Fax Number: | 2514707609 |
NPI Enumeration Date: | 02/09/2010 |
NPI Last Update Date: | 02/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1586 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |