Individual
PATRICIA ANN FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12465 WARWICK BLVD, NEWPORT NEWS, VA 23606-3041
(757) 591-4500
Mailing address
29 SMITH ST, POQUOSON, VA 23662-2029
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003979
VA
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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