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Individual
MRS. REBECCA JEAN FAHERTY
Active
Individual
MRS. REBECCA JEAN FAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LADC1, C-SWHC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1100
MA
1041C0700X
Clinical Social Worker
Primary
114617
MA
Other
Enumeration date
10/03/2006
Last updated
12/14/2010
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