Individual
MICHELLE FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 ASHLEY AVE, APT. A4, WEST SPRINGFIELD, MA 01089-1345
(413) 746-3452
Mailing address
131 ASHLEY AVE, APT. A4, WEST SPRINGFIELD, MA 01089-1345
(413) 746-3452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/22/2014
Last updated
03/25/2026
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