Individual
JACKLYN ANN FAIRCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.C., N.C.C
Contact information
Practice address
202 E BAGLEY RD, BEREA, OH 44017-2058
(440) 260-8453
Mailing address
5737 HARTNECK RD, VALLEY CITY, OH 44280-9767
(704) 763-8083
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1400045
OH
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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