Individual
MONIQUE TARVER FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7950 MARTIN LOOP, 4A OUTPATIENT MENTAL HEALTH, FORT BENNING, GA 31905-5647
(706) 544-3590
Mailing address
98 LEE ROAD 2000, SMITHS STATION, AL 36877-2476
(334) 448-8287
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1824C
AL
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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