Individual
JAIME CARLISLE FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4834 CROCKETT CT, RALEIGH, NC 27606-6304
(919) 357-2551
Mailing address
4834 CROCKETT CT, RALEIGH, NC 27606-6304
(919) 357-2551
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12064
NC
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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