Individual
KERI LYNN FAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC, CTRS
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30067
IL
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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