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1215647060
ROSE ANN FAIRCLOTH
PINEVILLE, LA
NPI
1215647060
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA CIT-5306)
Enumeration Date
2022-12-02
Last Update Date
2023-10-17
Business Address
ROSE ANN FAIRCLOTH CAC
5505 SHREVEPORT HWY
PINEVILLE, LA 71360-3533
Phone number: 318-730-3878
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Mailing Address
ROSE ANN FAIRCLOTH CAC
107 RUTH ST
PINEVILLE, LA 71360-6660
Phone number: 318-730-3878
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