Individual
JENNIFER FADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
3980 W WEDINGTON DR STE 9, FAYETTEVILLE, AR 72704-5791
(479) 263-7602
Mailing address
PO BOX 203, CENTERTON, AR 72719
(479) 903-1263
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P0301002
AR
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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