TARA KIM FAIRBANKS

CASPER, WY
NPI1780402115
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY  207)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2024-10-03
Last Update Date2024-10-17
Business Address
TARA KIM FAIRBANKS CAP - 207
1430 WILKINS CIR
CASPER, WY 82601-1336
Phone number: 307-237-9588
Mailing Address
TARA KIM FAIRBANKS CAP - 207
2424 E 9TH ST
CASPER, WY 82609-2838
Phone number: 307-267-7253