Provider Demographics
NPI:1194490334
Name:FAUBERT, ALISON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:FAUBERT
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 1:214 BURNS HOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:FORT COVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12937-2604
Mailing Address - Country:US
Mailing Address - Phone:201-675-5811
Mailing Address - Fax:
Practice Address - Street 1:31 6TH ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1246
Practice Address - Country:US
Practice Address - Phone:518-483-3261
Practice Address - Fax:518-483-8980
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist