INDY MARIE FAIRBANKS
Individual Provider (NPI-1)
Active
Social Worker, Clinical
Provider Information
- NPI Number
1013267756- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 402 N RIVER ST STE 200, DERBY, KS, 670371539
- Phone
- (316) 409-0565
Specialties & Taxonomies
Counselor, Addiction (Substance Use Disorder)
License: KS #647
Social Worker, Clinical
Primary License: KS #4661