COYOTE FAIRBANK

POLSON, MT
NPI1447783170
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: MT  BBH-LCSW-LIC-23635)
Enumeration Date2017-04-10
Last Update Date2023-11-27
Business Address
COYOTE FAIRBANK LCSW
2 6TH AVE E
POLSON, MT 59860-2726
Phone number: 406-214-3137
Mailing Address
COYOTE FAIRBANK LCSW
PO BOX 181
POLSON, MT 59860-0181
Phone number: 406-214-3137
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