Individual
JESSICA CHRISTIAN FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1830 OWEN DR STE 103, FAYETTEVILLE, NC 28304-3412
(910) 748-0258
Mailing address
338 HILLIARD DR, FAYETTEVILLE, NC 28311-2648
(910) 494-0222
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13735
NC
Other
Enumeration date
12/05/2020
Last updated
05/02/2022
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