Individual
DR. WILLIAM D FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LPC
Contact information
Practice address
2526 SEYMOUR AVE, CHEYENNE, WY 82001-3159
(307) 634-9653
(307) 638-8256
Mailing address
2526 SEYMOUR AVE, CHEYENNE, WY 82001-3159
(307) 634-9653
(307) 638-8256
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
261
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311734
BS OF WY
WY
01
—
MH60
WINHEALTH PARTNERS
WY
Enumeration date
12/05/2005
Last updated
03/15/2011
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