Individual
COURTNEY FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Mailing address
443 FOX CHASE RD, CHESTER, NJ 07930-3122
(610) 304-2440
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06260700
NJ
1041S0200X
School Social Worker
944398
NJ
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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