Individual
JESSICA FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
231 BELLE DR, SCOTTSBORO, AL 35769-3657
(256) 647-3574
Mailing address
231 BELLE DR, SCOTTSBORO, AL 35769-3657
(256) 647-3574
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3476
AL
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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