Individual
DEBRA ANN FADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC
Contact information
Practice address
106 AVENUE C, MATAMORAS, PA 18336-1046
(570) 877-0488
Mailing address
106 AVENUE C, MATAMORAS, PA 18336-1046
(570) 877-0488
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002268
NY
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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