Individual
ELIZABETH FAIRBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2200 SW GAGE BLVD, TOPEKA, KS 66622-0001
(785) 350-3111
Mailing address
2200 SW GAGE BLVD, TOPEKA, KS 66622
(785) 350-3111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW 3106
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW 3106
SOCIAL WORK LICENSE
KS
Enumeration date
04/02/2009
Last updated
04/02/2009
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