Provider Demographics
NPI:1295064186
Name:FAUDEL, KATHERINE ANDREA (MS, LMFT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANDREA
Last Name:FAUDEL
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:FAUDEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:525 ALBION WAY
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3249
Mailing Address - Country:US
Mailing Address - Phone:970-407-0404
Mailing Address - Fax:970-207-1961
Practice Address - Street 1:525 ALBION WAY
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-3249
Practice Address - Country:US
Practice Address - Phone:970-407-0404
Practice Address - Fax:970-207-1961
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO752106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist