IndividualActive
Candice Fountain
NPI 1629150818 · Driving and Community Mobility Occupational Therapist · Jackson, MS
Provider details
- NPI number
- 1629150818
- Entity type
- Individual
- Primary specialty
- Driving and Community Mobility Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- OT2019 (MS)
Practice location
2475 Lakeland Dr Ste a
Jackson, MS 39232-9505
Phone: (601) 636-6019
Fax: (601) 661-8457
Mailing address
1054 Highland Cove Pl
Ridgeland, MS 39157-1523
Registry dates
- Enumerated
- 2006-10-19
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.