| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KRISTINA NICOLE FAIRBANKS | 1033728043 | 2020-07-26 |
Kristina Nicole Fairbanks is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1033728043. Registration indicates Kristina Nicole Fairbanks is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Kristina Nicole Fairbanks MS |
| Practice Office Address | 1308 N MAIN ST CROWN POINT, IN US |
| Practice Office Telephone | 2196636353 |
| Mailing Address | 8694 FOREST GLEN CT SAINT JOHN, IN 463738424 US |
| Business Telephone | 6302173921 |
| Email [] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor |