Individual
JULIANNE FAIRBROTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
538 BROADHOLLOW RD, MELVILLE, NY 11747-3676
(631) 385-7780
Mailing address
11 HUBBELL ST, COMMACK, NY 11725-2008
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/27/2017
Last updated
07/27/2017
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