Provider Demographics
NPI:1700424538
Name:FOUNTAIN, LILIAN ELIZABETH (AUD)
Entity Type:Individual
Prefix:DR
First Name:LILIAN
Middle Name:ELIZABETH
Last Name:FOUNTAIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:FOUNTAIN
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:285 MCDOWELL STREET
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-252-1860
Mailing Address - Fax:828-259-9468
Practice Address - Street 1:285 MCDOWELL STREET
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-252-1860
Practice Address - Fax:828-259-9468
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7099231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist