Doctor Name: | RAYMOND L. FABING |
NPI Number: | 1457338717 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD, LPC |
License Number: | MO-CS001016 |
Business Practice Address: | 528 E Main St Park Hills, MO - 636012634 |
Business Phone Number: | 5734313341 |
Business Fax Number: | 5734315205 |
Mailing Address: | Po Box 506, PARK HILLS |
State: | MO |
Postal Code: | 636010506 |
Phone Number: | 5734310554 |
Fax Number: | 5734315205 |
NPI Enumeration Date: | 12/28/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | MO-CS001016 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |