Individual
LINDSAY FAIRFAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19251 MACK AVE STE M450, GROSSE POINTE WOODS, MI 48236-2893
(313) 343-1370
Mailing address
19251 MACK AVE # M450, GROSSE POINTE WOODS, MI 48236-2893
(313) 343-1370
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
12/15/2022
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