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General NPI Number Information
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NPI Number | 1013714021
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Entity Type | Organization
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Legal Business Name | FAZIO-EYNULLAYEVA COUNSELING LLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 977 WESTFORD ST APT 3
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City | LOWELL
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State | MA
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Zip | 01851-2709
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Country | US
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Telephone | 302-319-2364
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Fax |
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Provider Business Mailing Address
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Address Line | 844 INDEPENDENCE CT
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City | PHILADELPHIA
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State | PA
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Zip | 19147-4310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ROSALIE FAZIO-EYNULLAYEVA
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Credential | LCSW, LICSW
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Telephone | 302-319-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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