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1114363363
MARY KATHLEEN FAHY
ROSEVILLE, CA
NPI
1114363363
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-05-15
Last Update Date
2013-05-15
Business Address
-- MARY KATHLEEN FAHY IMFT
1133 COLOMA WAY
ROSEVILLE, CA 95661-4480
Phone number: 916-774-6647
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Mailing Address
-- MARY KATHLEEN FAHY IMFT
10066 WINKLE CIR
ELK GROVE, CA 95757-6275
Phone number: 203-767-5543
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