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MRS. KELLI JEAN FAIRRIS M.S.E., L.P.C
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1326220856
Individual Registrant:MRS. KELLI JEAN FAIRRIS M.S.E., L.P.C
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1658 US HIGHWAY 371 PRESCOTT, AR 71857-7064 US
Tel: 870-887-3660 Fax: 870-887-3705
Tel: 870-887-3660 Fax: 870-887-3705
Contact information for business:
1658 US HIGHWAY 371 PO BOX 357 PRESCOTT, AR 71857-7064 US
Tel: 870-887-3660 Fax: 870-887-3705
Tel: 870-887-3660 Fax: 870-887-3705
Registration Information:
NPI: 1326220856
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional | AR | P1011073 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
