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Individual

OCTAVIA LAINE FABRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
115 E AUGUSTA ST, MC CORMICK, SC 29835-8703
(864) 550-3900
Mailing address
227 SANDUSKY LN, SIMPSONVILLE, SC 29680-7719
(631) 295-7117

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
SC

Other

Enumeration date
05/12/2026
Last updated
05/13/2026
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