| Doctor Name: | MELISSA ROREX FOUNTAIN |
| NPI Number: | 1104267913 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 1450C |
| Business Practice Address: | 9064 Highway 431 S Owens Cross Roads, AL - 357638932 |
| Business Phone Number: | 2567253722 |
| Business Fax Number: | 2084984045 |
| Mailing Address: | 9064 Highway 431 S, P. O Box 305 OWENS CROSS ROADS |
| State: | AL |
| Postal Code: | 357638932 |
| Phone Number: | 2567253722 |
| Fax Number: | 2084984045 |
| NPI Enumeration Date: | 07/09/2013 |
| NPI Last Update Date: | 12/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1450C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |