Fairbanks, William D
Fairbanks, William D is an individual health care provider with primary practice located at 2526 Seymour Ave , Cheyenne WY 82001-3159. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Fairbanks, William D can be contacted via phone (307) 634-9653.Contact Information
Primary practice address
2526 Seymour Ave
Cheyenne WY 82001-3159
Phone: (307) 634-9653
Fax: (307) 638-8256
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 261 | Wyoming |
Profile Details
NPI number | 1114901964 |
---|---|
LBN Legal business name | Fairbanks, William D |
Credentials | PH.D., LPC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 5th, 2005 |
Last updated | Mar 15th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114901964 | NPPES |
Wyoming | Other | 311734 | BS OF WY |
Wyoming | Other | MH60 | BS OF WY |
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