| Doctor Name: | MARK ANTHONY FABIAN |
| NPI Number: | 1104930346 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | 4863 |
| Business Practice Address: | 57 E Main St Suite 200 Westborough, MA - 015811464 |
| Business Phone Number: | 5083660406 |
| Business Fax Number: | 5083666221 |
| Mailing Address: | 239 Exchange St., #2 MILLIS |
| State: | MA |
| Postal Code: | 020541219 |
| Phone Number: | 5083764405 |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4863 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |