Individual
AILEEN FAIRCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5009
(631) 726-8606
Mailing address
240 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5009
(631) 726-8606
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
08/09/2016
Last updated
04/09/2018
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