Individual
MIA FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
3565 LONE OAK RD STE 2, PADUCAH, KY 42003-5717
(270) 554-3714
Mailing address
3310 CENTRAL AVE, PADUCAH, KY 42001-4248
(270) 556-2370
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
287245
KY
Other
Enumeration date
09/21/2023
Last updated
10/02/2023
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