Individual
STACY M FAIREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1805 CLARK HILLS CIR, JOHNS ISLAND, SC 29455-7603
(843) 860-0683
Mailing address
1805 CLARK HILLS CIR, JOHNS ISLAND, SC 29455-7603
(843) 860-0683
Taxonomy
Speciality
Code
Description
License number
State
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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