Individual
ANNIE FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
Mailing address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW-1518
AZ
Other
Enumeration date
07/12/2007
Last updated
07/12/2007
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