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1639644958
AUDREY VANESSA FAIRCHILD
SAN CARLOS, CA
NPI
1639644958
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA AMFT109874)
Enumeration Date
2018-10-12
Last Update Date
2018-10-12
Business Address
Ms. AUDREY VANESSA FAIRCHILD AMFT APCC
1303 SAN CARLOS AVE
SAN CARLOS, CA 94070-2317
Phone number: 650-394-5155
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Mailing Address
Ms. AUDREY VANESSA FAIRCHILD AMFT APCC
981 SOUTH B STREET
SAN MATEO, CA 94401
Phone number: 650-492-0173
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