Provider Demographics
NPI:1205000627
Name:FAUST, PATRICE G
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:G
Last Name:FAUST
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:MONADNOCK FAMILY SERVICES
Mailing Address - Street 2:17 NINETY-THIRD STREET
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-357-5270
Mailing Address - Fax:
Practice Address - Street 1:MONADNOCK FAMILY SERVICES
Practice Address - Street 2:17 NINETY-THIRD STREET
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-357-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor