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NPI Code Detail

MEDICARE: ANDREEA ALEXANDRA FAUR

MEDICARE: ANDREEA ALEXANDRA FAUR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1386138212
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREEA ALEXANDRA FAUR
Provider Business Mailing Address
First Line : 20821 N 39TH DR
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-4614
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17235 N 75TH AVE STE F100
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-0871
Country : US
Telephone Number : 480-641-1165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2018
Last Update Date : 06/14/2018

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Directions to “ ANDREEA ALEXANDRA FAUR ” Practice Location

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