Individual provider · Type 1 NPI

Krystal Lynnette Fountain

Developmental Therapist · Chicago, IL

NPI number 1538680996 Active

Practice location

7806 S Wood St
Chicago, IL 60620-4446

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1538680996

Krystal Lynnette Fountain's National Provider Identifier is 1538680996, issued on Jul 6, 2017. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Chicago, IL. The record was last updated on Jul 6, 2017.