Individual
FAWN HEATHER LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSAC
Contact information
Practice address
98-211 PALI MOMI ST STE 520, AIEA, HI 96701-4328
(855) 223-7123
Mailing address
PO BOX 740780, ATLANTA, GA 30374-0780
(855) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/27/2021
Last updated
05/15/2026
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