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General NPI Number Information
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NPI Number | 1255890794
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Entity Type | Individual
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Provider Name | BENJAMIN JAMES FAUL LMFTA
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Gender | Male
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 925 N GOLIAD ST
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City | ROCKWALL
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State | TX
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Zip | 75087-2230
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Country | US
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Telephone | 214-548-1220
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Fax | 830-637-7438
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Provider Business Mailing Address
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Address Line | PO BOX 1731
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City | MARBLE FALLS
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State | TX
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Zip | 78654
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Country | US
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Telephone | 830-693-0530
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Fax | 830-637-7438
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203416
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License Number State | TX
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