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NPI Code Detail

MEDICARE: MS. BRENDA S FAIBER MS,LMFT

MEDICARE: MS. BRENDA S FAIBER MS,LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMT805FL

General Provider Information

NPI Number : 1760692958
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRENDA S FAIBER MS,LMFT
Provider Business Mailing Address
First Line : 455 DOUGLAS AVE STE 2155-7
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-2528
Country : US
Telephone Number : 407-869-6634
Fax Number :
Provider Business Practice Location Address
First Line : 801 N MAGNOLIA AVE STE 402
Second Line :
City : ORLANDO
State : FL
Zip : 32803-3844
Country : US
Telephone Number : 407-963-5664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 02/27/2019

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