| Doctor Name: | GINA N FARRELL |
| NPI Number: | 1407906985 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | 4076 |
| Business Practice Address: | 272 S. Columbia Ave Rincon, GA - 31326 |
| Business Phone Number: | 9126585392 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2045, RINCON |
| State: | GA |
| Postal Code: | 313262045 |
| Phone Number: | 9126585392 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 11/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |