Doctor Name: | MS. AUDREY FARRELL |
NPI Number: | 1437428166 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 227.013694 |
Business Practice Address: | 1834 W North Ave # 1 Chicago, IL - 606221312 |
Business Phone Number: | 7732279150 |
Business Fax Number: | 7732279160 |
Mailing Address: | 1931 W Evergreen Ave Apt 3, CHICAGO |
State: | IL |
Postal Code: | 606226958 |
Phone Number: | 3128020493 |
Fax Number: | 7732279160 |
NPI Enumeration Date: | 12/27/2011 |
NPI Last Update Date: | 12/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 227.013694 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |