Individual provider · Type 1 NPI
Tara Kim Fairbanks, CAP - 207
Addiction (Substance Use Disorder) Counselor · Casper, WY
NPI number
1780402115
Active
Practice location
1430 Wilkins Cir
Casper, WY 82601-1336
Mailing address
2424 E 9th St
Casper, WY 82609-2838
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 207 (WY) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1780402115
Tara Kim Fairbanks, CAP - 207's National Provider Identifier is 1780402115, issued on Oct 3, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Casper, WY. The record was last updated on Oct 17, 2024.