Individual
MICHELLE MARIE FADDOUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW#16997
Contact information
Practice address
2626 N. RIVER ROAD, TUCSON, AZ 85718
(520) 694-7021
Mailing address
2626 N. RIVER ROAD, TUCSON, AZ 85718
(520) 694-7021
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
28831
CA
1041C0700X
Clinical Social Worker
Primary
16997
AZ
Other
Enumeration date
09/08/2011
Last updated
05/04/2020
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