Doctor Name: | MS. MANDI FARLEY |
NPI Number: | 1548623564 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | 71149 |
Business Practice Address: | 7945 Pronghorn Dr Spring Branch, TX - 780704050 |
Business Phone Number: | 5128000900 |
Business Fax Number: | |
Mailing Address: | 7945 Pronghorn Dr, SPRING BRANCH |
State: | TX |
Postal Code: | 780704050 |
Phone Number: | 5128000900 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2016 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 71149 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |