Individual
DR. JEAN FAHEY
Active
Individual
DR. JEAN FAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1376
ME
174400000X
Specialist
PS1376
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6698
LICENSE NUMBER
MA
Enumeration date
12/15/2006
Last updated
11/07/2019
Update your record
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