Individual
DEIDRE L FAIRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1260 NE WINDSOR DR, LEES SUMMIT, MO 64086-5594
(816) 347-8777
(816) 474-7671
Mailing address
900 E LAHARPE ST, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002331
MO
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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