Provider Demographics
NPI:1053979609
Name:FAIRCHILD, EMILY JOAN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOAN
Last Name:FAIRCHILD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 MERRICK CT APT 229
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3721
Mailing Address - Country:US
Mailing Address - Phone:859-797-5731
Mailing Address - Fax:
Practice Address - Street 1:3434 MERRICK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3745
Practice Address - Country:US
Practice Address - Phone:859-797-5731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist