Individual provider · Type 1 NPI

Waverly Fair

Mental Health Counselor · Fairbanks, AK

NPI number 1356694012 Active

Practice location

3830 S Cushman St
Fairbanks, AK 99701-7530

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1356694012

Waverly Fair's National Provider Identifier is 1356694012, issued on Oct 18, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fairbanks, AK. The record was last updated on Oct 18, 2012.