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Contact Information

KHAILITHA FAE, L. AC, DOM
119 GARDEN ST STE B
PRESCOTT, AZ86305-2913
 Phone: 928-225-1655
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for KHAILITHA FAE · (Female)

NPI # 1972913234
Status Active
Credentials L. AC, DOM
Entity Individual
Enumeration date 05/07/2014
Last updated 05/07/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 0780
  • NM License # 1020
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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