Individual
MS. MICHELLE DAWN FAIRBANKS
Active
Individual
MS. MICHELLE DAWN FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADULT FOSTER CARE
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1049904
MN
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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