Doctor Name: | MARILYN FARR |
NPI Number: | 1093969065 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPCI |
License Number: | 1365486009 |
Business Practice Address: | 5541 Prospero Ln Herriman, UT - 840961816 |
Business Phone Number: | 8015487639 |
Business Fax Number: | 8019994466 |
Mailing Address: | 5541 Prospero Ln, HERRIMAN |
State: | UT |
Postal Code: | 840961816 |
Phone Number: | 8015487639 |
Fax Number: | 8019994466 |
NPI Enumeration Date: | 11/04/2008 |
NPI Last Update Date: | 11/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1365486009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |