Individual
MRS. MAKENZIE SHAE FAIRCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6316 E 102ND ST # 102, TULSA, OK 74137-7061
(918) 221-8382
Mailing address
204 W 45TH PL, SAND SPRINGS, OK 74063-2379
(918) 859-4422
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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