Provider Demographics
NPI:1326780644
Name:FAHRNBACH, DAWN ELIZABETH (MA, OBAT NAVIGATOR)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:FAHRNBACH
Suffix:
Gender:F
Credentials:MA, OBAT NAVIGATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MANHEIM AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-2139
Mailing Address - Country:US
Mailing Address - Phone:856-455-2700
Mailing Address - Fax:
Practice Address - Street 1:105 MANHEIM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-2139
Practice Address - Country:US
Practice Address - Phone:856-455-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)