Individual provider · NPI-1

Gabrielle Fountain, LMT

Massage Therapist · Augusta, GA

NPI number1669237632
StatusActive
Last updated in NPPESFeb 24, 2024

Details

NPI
1669237632
Entity type
Individual (NPI-1)
Name
Gabrielle Fountain
Credential
LMT
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 19, 2024
Certification date
Feb 24, 2024
Last updated
Feb 24, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMT014891GAYes

Practice location

680 Crane Creek Dr Apt 427
Augusta, GA 30907-3091

Phone 850-450-8156

Mailing address

680 Crane Creek Dr Apt 427
Augusta, GA 30907-3091

Phone 850-450-8156

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Massage Therapist providers in Augusta, GA