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Individual

DR. LARRY DON FAISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
18311 WISCONSIN STREET, ROBERTSDALE, AL 36567
(251) 605-6927
(251) 625-2625
Mailing address
27787 MONIAC CV, DAPHNE, AL 36526-6337
(251) 626-3105
(251) 625-2625

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
322
AL
101YM0800X
Mental Health Counselor
Primary
322
AL

Other

Enumeration date
10/15/2009
Last updated
10/15/2009
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