Healthcare Provider Details

I. General information

NPI: 1356352793
Provider Name (Legal Business Name): JAN FAERI PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 06/07/2022
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6457 REFLECTIONS DR STE 120
DUBLIN OH
43017-2352
US

IV. Provider business mailing address

6457 REFLECTIONS DR STE 120
DUBLIN OH
43017-2352
US

V. Phone/Fax

Practice location:
  • Phone: 614-792-1108
  • Fax: 614-792-0018
Mailing address:
  • Phone: 614-792-1108
  • Fax: 614-792-0018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4350
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: