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Individual

MRS. JENNIFER MARIE FABRE FAIRLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T. PH.D. CSCS

Contact information

Practice address
1901 HIGHWAY 190 STE 26, MANDEVILLE, LA 70448-3495
(985) 778-2282
(866) 767-8329
Mailing address
1901 HIGHWAY 190 STE 26, MANDEVILLE, LA 70448-3495
(985) 778-2282
(866) 767-8329

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04964
LA
225100000X
Physical Therapist
4135
NM

Other

Enumeration date
06/13/2005
Last updated
09/14/2022
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