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1265128797
AMANDA JANE FAIRBANKS
AMERICAN FORK, UT
NPI
1265128797
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Former Name
AMANDA JANE KERSHAW
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
Enumeration Date
2023-04-17
Last Update Date
2023-04-17
Business Address
AMANDA JANE FAIRBANKS
384 E 60 S
AMERICAN FORK, UT 84003-3835
Phone number: 801-901-0279
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Mailing Address
AMANDA JANE FAIRBANKS
5767 W YORKSHIRE CT
HIGHLAND, UT 84003-3924
Phone number: 801-616-6322
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