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Individual

JENNIFER RAE FAIRBAIRN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT

Contact information

Practice address
2470 CHANATE RD, SANTA ROSA, CA 95404-2110
(707) 326-5373
Mailing address
2470 CHANATE RD, SANTA ROSA, CA 95404-2110
(707) 326-5373

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
31385
CA

Other

Enumeration date
09/03/2020
Last updated
09/03/2020
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