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Contact Information

CANDICE FOUNTAIN
2475 LAKELAND DR STE A
JACKSON, MS39232-9505
 Phone: 601-636-6019
 Fax: 601-661-8457
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Driving and Community Mobility

225XR0403X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CANDICE FOUNTAIN · (Female)

NPI # 1629150818
Status Active
Credentials
Entity Individual
Enumeration date 10/19/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MS License # OT2019
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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