Fountain, Candice

Fountain, Candice is an individual health care provider with primary practice located at 2475 Lakeland Dr Ste A , Jackson MS 39232-9505. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Driving and Community Mobility, which is considered as her primary health care specialty. Fountain, Candice can be contacted via phone (601) 636-6019.

Contact Information

Primary practice address
2475 Lakeland Dr Ste A Jackson MS 39232-9505
Phone: (601) 636-6019
Fax: (601) 661-8457
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Driving and Community Mobility 225XR0403X OT2019 Mississippi

Profile Details

NPI number 1629150818
LBN Legal business name Fountain, Candice
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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