| Doctor Name: | MS. JANICE LESLIE FAIRCHILD |
| NPI Number: | 1164620043 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS |
| License Number: | LC2857 |
| Business Practice Address: | 500 S Main St Suite 101b North East, MD - 219013920 |
| Business Phone Number: | 4438774044 |
| Business Fax Number: | 4435057065 |
| Mailing Address: | 500 S Main St, NORTH EAST |
| State: | MD |
| Postal Code: | 219013920 |
| Phone Number: | 4438774044 |
| Fax Number: | 4435057065 |
| NPI Enumeration Date: | 07/03/2007 |
| NPI Last Update Date: | 07/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC2857 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |