Doctor Name: | ELBERT FARMER |
NPI Number: | 1003284548 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 32 S Macdonald Mesa, AZ - 852101310 |
Business Phone Number: | 4806961471 |
Business Fax Number: | 4802640687 |
Mailing Address: | 32 S Macdonald, MESA |
State: | AZ |
Postal Code: | 852101310 |
Phone Number: | 4806961471 |
Fax Number: | 4802640687 |
NPI Enumeration Date: | 09/14/2015 |
NPI Last Update Date: | 09/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |