Individual
STEPHANI FAUERBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3809 N TAMPA ST, TAMPA, FL 33603-4743
(813) 872-6250
(813) 872-6078
Mailing address
3809 N TAMPA ST, TAMPA, FL 33603-4743
(813) 872-6250
(813) 872-6078
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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