Individual
KATHLEEN L FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
618 N 8TH ST, POPLAR BLUFF, MO 63901-5023
(573) 429-0513
Mailing address
618 N 8TH ST, POPLAR BLUFF, MO 63901-5023
(573) 429-0513
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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