Individual
MEREDITH MICHELLE FANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1011 LEHMAN AVENUE, SUITE 103, BOWLING GREEN, KY 42103-6515
(270) 393-9833
(270) 393-9835
Mailing address
1011 LEHMAN AVENUE, SUITE 103, BOWLING GREEN, KY 42103-6515
(270) 393-9833
(270) 393-9835
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252723
KY
1041C0700X
Clinical Social Worker
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7145
MASTER IN SOCIAL WORK
KY
01
—
PENDING
MASTERS SOCIAL WORK
—
Enumeration date
05/12/2011
Last updated
07/23/2018
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