Individual
SANDRA FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12401 E 43RD ST S, INDEPENDENCE, MO 64055-5907
(816) 699-0103
Mailing address
1608 S HARRIS AVE, INDEPENDENCE, MO 64052-3730
(816) 699-0103
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2024042652
MO
1041C0700X
Clinical Social Worker
Primary
2024042652
MO
Other
Enumeration date
01/09/2023
Last updated
01/27/2026
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