Individual
LIBBIE ANNE FAIRCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3307 CALDWELL BLVD, NAMPA, ID 83651-6402
(208) 465-4833
Mailing address
10334 HAZY GLEN DR, NAMPA, ID 83687-7929
(808) 931-0274
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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