Female

Kimberly Fountain

Day Training/Habilitation Specialist in Russellville, AR(View on Map)

Full Name

Kimberly Fountain

NPI Number

1154836161

NPI Type

Individual Provider

Gender

Female

Enumeration Date

12/13/2017

Specialties

(Taxonomies)

Code

373H00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 2109
1301 RUSSELL RD

City

Russellville
Russellville

State

AR
AR

Postal Code

72811-2109
72802-4320

Country

US
US

Telephone Number

N/A
(479) 967-2322

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/13/2017

Provider Address

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