Individual
MISS CHANTAL DENISE FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
904 ISAAC STREETS DR, OREGON, OH 43616-3204
(419) 691-2483
Mailing address
540 APPLE AVE, TOLEDO, OH 43609-1718
(419) 389-5351
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA2545
OH
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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