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Individual

OLIVIA FADUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
14 ALVARADO PL, BERKELEY, CA 94705-1507
(256) 527-8240
Mailing address
14 ALVARADO PL, BERKELEY, CA 94705-1507
(256) 527-8240

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3246
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
AM NOT REGISTERED WITH INSURANCE
AL
Enumeration date
03/02/2018
Last updated
03/02/2018
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