Individual
MS. JANE ELIZABETH FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
572 BANGOR RD, DOVER FOXCROFT, ME 04426
(207) 564-2464
Mailing address
572 BANGOR RD, DOVER FOXCROFT, ME 04426
(207) 564-2464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8922
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431701999
—
ME
Enumeration date
02/07/2007
Last updated
11/17/2008
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