| Doctor Name: | MRS. FARRA O CRISWELL |
| NPI Number: | 1144311440 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | |
| Business Practice Address: | 12 Marion St. Life Seasons Counseling Pontotoc, MS - 38863 |
| Business Phone Number: | 6622978509 |
| Business Fax Number: | |
| Mailing Address: | 2660 Eddington Rd, PONTOTOC |
| State: | MS |
| Postal Code: | 388638198 |
| Phone Number: | 6622138927 |
| Fax Number: | |
| NPI Enumeration Date: | 09/28/2006 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |