Individual
KENNETH WILLIAM FAUSETT SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
276 LAKE HAVASU AVE S APT C32, LAKE HAVASU CITY, AZ 86403-6521
(928) 813-8977
Mailing address
276 LAKE HAVASU AVE S APT C32, LAKE HAVASU CITY, AZ 86403-6521
(928) 813-8977
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-15484
AZ
Other
Enumeration date
06/19/2020
Last updated
09/17/2020
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