Provider Demographics
NPI:1568344612
Name:FAHNER, CORINNE
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:FAHNER
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 1:3901 WOODCHASE DR UNIT 40
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-5833
Mailing Address - Country:US
Mailing Address - Phone:832-410-6412
Mailing Address - Fax:
Practice Address - Street 1:10101 FONDREN RD STE 550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5149
Practice Address - Country:US
Practice Address - Phone:713-510-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst