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Individual

KATHRYN ELIZABETH FAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSC

Contact information

Practice address
25 E PARK AVE STE 8, DU BOIS, PA 15801-2271
(814) 371-3763
(814) 371-4638
Mailing address
25 E PARK AVE, DU BOIS, PA 15801-2271
(814) 335-6510
(814) 371-4638

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002382
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BH002382
PA BUREAU OF PROFESSIONAL & OCCUPATIONAL AFAIRS
PA
Enumeration date
05/15/2019
Last updated
05/15/2019
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