Eddie Fountain

NPI #1295182889 in Tallulah, Louisiana

Provider Information

NPI Number: 1295182889
Entity Type: Individual
Name: Eddie Fountain
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: May 24, 2016
Last Updated: May 24, 2016

Practice Location

Address: 1705 FELICIA AVE
City: Tallulah
State: Louisiana
ZIP Code: 71282-8203
Phone: (318) 574-1232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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