Individual provider · Type 1 NPI

Mary Kathleen Fahy, IMFT

Addiction (Substance Use Disorder) Counselor · Roseville, CA

NPI number 1114363363 Active

Practice location

1133 Coloma Way
Roseville, CA 95661-4480

Call (916) 774-6647 Map

Mailing address

10066 Winkle Cir
Elk Grove, CA 95757-6275

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1114363363

Mary Kathleen Fahy, IMFT's National Provider Identifier is 1114363363, issued on May 15, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Roseville, CA. The record was last updated on May 15, 2013.