Doctor Name: | STEPHANIE FAREBROTHER |
NPI Number: | 1154719920 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLPC |
License Number: | |
Business Practice Address: | 306 S Independence St Harrisonville, MO - 647012352 |
Business Phone Number: | 8163804010 |
Business Fax Number: | 8168875703 |
Mailing Address: | 815 S Ash St, NEVADA |
State: | MO |
Postal Code: | 647723222 |
Phone Number: | 4176678352 |
Fax Number: | 4176679216 |
NPI Enumeration Date: | 01/02/2015 |
NPI Last Update Date: | 01/02/2015 |
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: |