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General NPI Number Information
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NPI Number | 1851431480
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Entity Type | Individual
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Provider Name | FAY COLEMAN IMFT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8912 VOLUNTEER LN STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95826-3224
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Country | US
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Telephone | 916-368-3080
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 VILLAGIO DR
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-5527
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Country | US
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Telephone | 916-284-8964
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 45708
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License Number State | CA
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