Individual
CALLISTA RAY FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Mailing address
1409 W 3RD ST APT 5D, CHICO, CA 95928-4803
(850) 865-9963
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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