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Provider Information for 1710201991


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Mrs. KAREN MARIE FAIN MFT


Other Names:  
Former Name: 
Miss KAREN MARIE WRIGHT

Sex: Female

NPI: 1710201991
Last Updated: 2010-03-17
Certification Date:

Details

NameValue
NPI1710201991
Enumeration Date2010-03-17
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 4414 N 19TH AVE
PHOENIX, AZ 85015-4114
United States

Phone: 602-285-5550 | Fax:602-285-5551
 
Primary Practice Address 4414 N 19TH AVE
PHOENIX, AZ 85015-4114
United States

Phone: 602-285-5550 | Fax:602-285-5551
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist