Individual
BARBARA JEAN FAIRFAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
220 RONNIE CT STE 2, MYRTLE BEACH, SC 29579-4192
(910) 880-0575
Mailing address
583 OLD CARTRETTE RD, CLARENDON, NC 28432-8819
(910) 880-0575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A11193
NC
Other
Enumeration date
05/11/2015
Last updated
05/16/2022
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