Provider Demographics
NPI:1699816793
Name:HART, FABRIENNE N
Entity Type:Individual
Prefix:MRS
First Name:FABRIENNE
Middle Name:N
Last Name:HART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FABRIENNE
Other - Middle Name:
Other - Last Name:ROOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4538 W CRAIG RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2508
Mailing Address - Country:US
Mailing Address - Phone:702-486-5597
Mailing Address - Fax:
Practice Address - Street 1:4538 W CRAIG RD
Practice Address - Street 2:SUITE 290
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2508
Practice Address - Country:US
Practice Address - Phone:702-486-5597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling