Individual
DAJIA FAIRMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 KIRKMAN ST STE A, LAKE CHARLES, LA 70601-5391
(337) 990-5305
(337) 990-5306
Mailing address
1202 KIRKMAN ST STE A, LAKE CHARLES, LA 70601-5391
(337) 990-5305
(337) 990-5306
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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