Provider Demographics
NPI:1699923391
Name:MALES, FABIANA M (LPC)
Entity type:Individual
Prefix:MS
First Name:FABIANA
Middle Name:M
Last Name:MALES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FOX HUNT LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-6277
Mailing Address - Country:US
Mailing Address - Phone:405-473-6980
Mailing Address - Fax:405-340-6980
Practice Address - Street 1:2 E 11TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034
Practice Address - Country:US
Practice Address - Phone:405-473-6980
Practice Address - Fax:340-473-6980
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1248101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health