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Individual

AUSTIN FISHBACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4505 W DEYOUNG ST STE 203C, MARION, IL 62959-5899
(618) 283-2222
Mailing address
407 BAINBRIDGE RD, MARION, IL 62959-1313
(618) 694-9409

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/25/2021
Last updated
05/25/2021
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