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Individual
MS. LISA A FAIRES
Active
Individual
MS. LISA A FAIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. LCPC,LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH 13040
FL
101YP2500X
Professional Counselor
CC3775
ME
Other
Enumeration date
11/10/2009
Last updated
02/27/2015
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