Mikala Fairbanks

NPI #1306391370 in Orem, Utah

Provider Information

NPI Number: 1306391370
Entity Type: Individual
Name: Mikala Fairbanks
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Aug 19, 2016
Last Updated: Aug 19, 2016

Practice Location

Address: 638 N 450 W
City: Orem
State: Utah
ZIP Code: 84057-3794
Phone: (801) 373-4760

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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