NPI | 1649846874 |
---|---|
Doing Business As | DR. COLLEEN M. FAIRBANKS, LLC |
Entity Type | Organization |
Authorized Contact | COLLEEN MARIE FAIRBANKS Licensed Clinical Psychologist 630-903-3854 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2021-05-28 |
Last Update Date | 2021-05-28 |