Individual
DELISE N FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 SHATTUCK AVE, BERKELEY, CA 94704-1345
(757) 768-0882
Mailing address
PSC 473 BOX 1155, FPO, AP 96349-0012
(407) 412-3933
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
15865
SC
104100000X
Social Worker
Primary
MSW011146
GA
Other
Enumeration date
03/24/2023
Last updated
03/24/2023
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