Individual
TAKEYA FAISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
172 NEWBURY ST, PEABODY, MA 01960-2405
(978) 535-9190
Mailing address
172 NEWBURY ST, PEABODY, MA 01960-2405
(978) 535-9190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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