MRS. Portia L Fountain, MS CCC-SLP
NPI #1578074845 in Oxford, Mississippi
Provider Information
- NPI Number
- 1578074845
- Entity Type
- Individual
- Name
- MRS. Portia L Fountain, MS CCC-SLP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Speech-Language Pathologist
- Credential
- MS CCC-SLP
- Enumeration Date
- Oct 13, 2017
- Last Updated
- Oct 13, 2017
Practice Location
- Address
- 12007 WATER RIDGE DR
- City
- Oxford
- State
- Mississippi
- ZIP Code
- 38655-6015
- Phone
- (662) 801-8064
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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