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1720794712
KIM STAFFORD FAHLEN
SAN RAFAEL, CA
NPI
1720794712
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 41746)
Enumeration Date
2023-01-24
Last Update Date
2023-01-24
Business Address
KIM STAFFORD FAHLEN LMFT
875 4TH ST STE 6
SAN RAFAEL, CA 94901-3242
Phone number: 415-578-2978
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Mailing Address
KIM STAFFORD FAHLEN LMFT
23 HACIENDA CT
SAN RAFAEL, CA 94901-1314
Phone number: 415-205-4034
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