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Individual

MR. JEFF JOSEPH FAUQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
920 4TH AVE N, GREAT FALLS, MT 59401-1514
(406) 727-8892
(406) 727-8172
Mailing address
920 4TH AVE N, GREAT FALLS, MT 59401-1514
(406) 727-8892
(406) 727-8172

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
810410694
MT

Other

Enumeration date
08/09/2013
Last updated
08/09/2013
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