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General NPI Number Information
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NPI Number | 1538813522
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Entity Type | Individual
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Provider Name | CATHERINE FANG LPC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 214 W MAIN ST
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City | SOMERTON
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State | AZ
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Zip | 85350-6329
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Country | US
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Telephone | 928-627-1120
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Fax | 928-722-6113
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | SOMERTON
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State | AZ
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Zip | 85350-0617
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Country | US
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Telephone | 928-315-7910
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Fax | 928-722-6113
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-20590
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License Number State | AZ
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