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Individual

ELISE S FAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
2624 18TH AVE, GREELEY, CO 80631-4024
(970) 674-3155
Mailing address
2624 18TH AVE, GREELEY, CO 80631-8111
(970) 352-6120

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3797
CO

Other

Enumeration date
10/19/2005
Last updated
04/05/2013
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