Individual
NICOLE FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
600 SCHOOL ST, JASPER SCHOOL DISTRICT, JASPER, AR 72641-8802
(870) 446-9305
(870) 446-6754
Mailing address
600 SCHOOL ST, JASPER SCHOOL DISTRICT, JASPER, AR 72641-8802
(870) 446-9305
(870) 446-6754
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2002031917
MO
101YS0200X
School Counselor
Primary
P1011074
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497205401
—
MO
Enumeration date
07/12/2005
Last updated
04/02/2015
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