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General NPI Number Information
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NPI Number | 1255887378
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Entity Type | Individual
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Provider Name | COLLEEN NICHOLE FABER
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Gender | Female
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 420 GROVE ST
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City | RICHWOOD
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State | OH
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Zip | 43344-9022
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Country | US
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Telephone | 740-943-3113
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Fax |
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Provider Business Mailing Address
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Address Line | 33250 WELLWOOD RD
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City | WEST MANSFIELD
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State | OH
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Zip | 43358-9693
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Country | US
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Telephone | 740-361-5901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | COND.2017136
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.12635
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License Number State | OH
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