| Dr Fairall And Associates Behavioral Health And Family Mediation Servi | |
|
4400 Marsh Landing Blvd Suite 1 Ponte Vedra Beach FL 32082-7215 | |
| (904) 463-2284 | |
| Not Available |
| Full Name | Dr Fairall And Associates Behavioral Health And Family Mediation Servi |
|---|---|
| Speciality | Psychologist |
| Location | 4400 Marsh Landing Blvd, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Laurie Fairall (OWNER) |
| Authorized Official Contact | 9044632284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Fairall And Associates Behavioral Health And Family Mediation Servi 117 Old Mill Ct Ponte Vedra Beach FL 32082-4133 Ph: (904) 463-2284 | Dr Fairall And Associates Behavioral Health And Family Mediation Servi 4400 Marsh Landing Blvd Suite 1 Ponte Vedra Beach FL 32082-7215 Ph: (904) 463-2284 |
| NPI Number | 1083088165 |
|---|---|
| Provider Enumeration Date | 11/30/2015 |
| Last Update Date | 11/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083088165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY 7675 (Florida) | Primary |
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