| Doctor Name: | DR. ANDREA F FACCI |
| NPI Number: | 1942471503 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D |
| License Number: | LCAS 1057 |
| Business Practice Address: | 5108 N Croatan Hwy Suite 311 Kitty Hawk, NC - 279493988 |
| Business Phone Number: | 2522551847 |
| Business Fax Number: | 2524801800 |
| Mailing Address: | Po Box 2286, KITTY HAWK |
| State: | NC |
| Postal Code: | 279492286 |
| Phone Number: | 2522551847 |
| Fax Number: | 2524801800 |
| NPI Enumeration Date: | 03/21/2008 |
| NPI Last Update Date: | 03/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LCAS 1057 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |