Individual
CASSONDRA DANIELLE FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHCA
Contact information
Practice address
227 W MOREHEAD ST STE 2, REIDSVILLE, NC 27320-3872
(336) 908-3927
Mailing address
2095 PINEY MOUNTAIN RD APT A, WALNUT COVE, NC 27052-7803
(336) 813-8523
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A19129
NC
Other
Enumeration date
08/17/2023
Last updated
08/21/2023
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