Individual
AMY LOUISE FAULSTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 5TH AVE, SUITE 150, SAN RAFAEL, CA 94901-2959
(415) 457-6964
Mailing address
15 SAN RAFAEL AVE, APT. 4, SAN ANSELMO, CA 94960-2118
(415) 827-4843
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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