Provider Demographics
NPI:1447511860
Name:FOUNTAIN, AMINATA (DPT)
Entity type:Individual
Prefix:DR
First Name:AMINATA
Middle Name:
Last Name:FOUNTAIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 HANOVER PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2010
Mailing Address - Country:US
Mailing Address - Phone:301-446-1644
Mailing Address - Fax:301-446-9056
Practice Address - Street 1:7500 HANOVER PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2010
Practice Address - Country:US
Practice Address - Phone:301-446-1644
Practice Address - Fax:301-446-9056
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD239932251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic