Individual
CHARLES JOSEPH FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 KEVIN RD, APALACHICOLA, FL 32320-1214
(404) 301-9914
Mailing address
113 KEVIN RD, APALACHICOLA, FL 32320-1214
(404) 301-9914
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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