Individual
ANDREA FACKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-INTERN
Contact information
Practice address
4425 S. MOPAC EXPRESSWAY, BUILDING 3, SUITE 503, AUSTIN, TX 78735
(512) 270-1513
Mailing address
3115 S 1ST ST APT 201, AUSTIN, TX 78704-6365
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
83581
TX
Other
Enumeration date
07/03/2020
Last updated
07/07/2020
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