Individual
DEANNA FAIRBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
300 SEAPORT LN UNIT 1210, MOUNT PLEASANT, SC 29464-3098
(551) 427-4287
Mailing address
300 SEAPORT LN UNIT 1210, MOUNT PLEASANT, SC 29464-3098
(551) 427-4287
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8077
SC
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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