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Organization
FAIRBANK COUNSELING, PLLC
Active
Organization
FAIRBANK COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COYOTE FAIRBANK LCSW (OWNER)
(406) 214-3137
Entity
Organization
Contact information
Practice address
2 6TH AVE E, POLSON, MT 59860-2726
(406) 214-3137
Mailing address
PO BOX 181, POLSON, MT 59860-0181
(406) 214-3137
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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