Individual
KRISTINA NICOLE FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1308 N MAIN ST, CROWN POINT, IN 46307-2719
(219) 663-6353
Mailing address
8694 FOREST GLEN CT, SAINT JOHN, IN 46373-8424
(630) 217-3921
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/26/2020
Last updated
07/26/2020
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