Provider Demographics
NPI:1932562626
Name:ADAM, FAKIYA
Entity Type:Individual
Prefix:
First Name:FAKIYA
Middle Name:
Last Name:ADAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 S CHAMBERS RD APT W205
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3566
Mailing Address - Country:US
Mailing Address - Phone:970-691-7705
Mailing Address - Fax:
Practice Address - Street 1:862 S CHAMBERS RD APT W205
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3566
Practice Address - Country:US
Practice Address - Phone:970-691-7705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health