Organization
COMPLETE BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY LYNN FAIRBANKS PSYD (MANAGER/DIRECTOR)
(402) 417-8793
Entity
Organization
Contact information
Practice address
5414 S 99TH ST, OMAHA, NE 68127-3214
(402) 417-8793
(402) 559-9592
Mailing address
5414 S 99TH ST, OMAHA, NE 68127-3214
(402) 417-8793
(402) 559-9592
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
748
NE
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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