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1255689022
ANDREA K-P FAFFORD
KENOSHA, WI
NPI
1255689022
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Former Name
ANDREA K PERATT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 7912-123)
Enumeration Date
2012-08-27
Last Update Date
2020-07-13
Business Address
ANDREA K-P FAFFORD LCSW
6501 3RD AVE
KENOSHA, WI 53143-5111
Phone number: 262-914-6540
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Mailing Address
ANDREA K-P FAFFORD LCSW
3708 16TH AVE
KENOSHA, WI 53140-2441
Phone number: 414-218-3413
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