Individual
MARY HEATHER FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
143 BAER ST, HUNTINGTON, WV 25705-1113
(304) 638-5156
Mailing address
143 BAER ST, HUNTINGTON, WV 25705-1113
(304) 638-5156
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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