Individual
MRS. KELLI JEAN FAIRRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.E., L.P.C
Contact information
Practice address
1127 SECOND ST, LAKE VILLAGE, AR 71653-1541
(870) 265-3808
Mailing address
790 ROBERTS DR, MONTICELLO, AR 71655-5723
(870) 367-2461
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1011073
AR
Other
Enumeration date
11/27/2007
Last updated
12/29/2025
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