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General NPI Number Information
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NPI Number | 1023446143
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Entity Type | Organization
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Legal Business Name | FABIANAS' ENTERPRISES, INC.
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 2 E 11TH ST
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City | EDMOND
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State | OK
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Zip | 73034-3922
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Country | US
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Telephone | 405-473-6980
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Fax | 405-340-6980
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Provider Business Mailing Address
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Address Line | 600 FOX HUNT LN
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City | EDMOND
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State | OK
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Zip | 73003-6277
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Country | US
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Telephone | 405-473-6980
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Fax | 405-340-6980
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Authorized Official
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Title or Position | PRESIDENT
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Name | FABIANA MALES
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Credential | LPC
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Telephone | 405-473-6980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1248
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License Number State | OK
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