Individual
SHIRICKA LASHAYE FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
5115 MINTVALE DR, CHARLOTTE, NC 28269-1689
(704) 906-5558
Mailing address
5115 MINTVALE DR, CHARLOTTE, NC 28269-1689
(704) 906-5558
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
7057A
NC
101YM0800X
Mental Health Counselor
7057A
NC
101YP2500X
Professional Counselor
7057A
NC
101YS0200X
School Counselor
7057A
NC
106H00000X
Marriage & Family Therapist
Primary
7057A
NC
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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