Individual
CYNTHIA A FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
650 JOEL DR., BEHAVIORAL HEALTH, FORT CAMPBEL, KY 42223
(785) 706-3409
Mailing address
BACH HOSPITAL 650 JOEL DR, FORT CAMPBELL, KY 42223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11150
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
326450099
MAINE CARE NUMBER
ME
Enumeration date
03/26/2007
Last updated
04/25/2025
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