Individual
JAMES FAUERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0018
Mailing address
PO BOX 64260, BALTIMORE, MD 21264-4260
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
02939
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331900800
—
MD
Enumeration date
06/23/2006
Last updated
01/23/2014
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