| Doctor Name: | DR. KRISTINE SIESEL FAUVER |
| NPI Number: | 1538538095 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ED.D. |
| License Number: | |
| Business Practice Address: | 205 Nolan Parkway Nwoesc Archbold, OH - 43502 |
| Business Phone Number: | 5674444808 |
| Business Fax Number: | 5644444804 |
| Mailing Address: | 13331 Bishop Rd., BOWLING GREEN |
| State: | OH |
| Postal Code: | 43402 |
| Phone Number: | 4193520354 |
| Fax Number: | |
| NPI Enumeration Date: | 09/15/2015 |
| NPI Last Update Date: | 09/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |