Basic Information
| Provider Information | |||||||||
| NPI: | 1639666035 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARR | ||||||||
| FirstName: | BRIANNA | ||||||||
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| Credential: | SWT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3747 VILLAGE DR APT L | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450055658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195758636 | ||||||||
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| Practice Location | |||||||||
| Address1: | 953 S SOUTH ST | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451772921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373834441 | ||||||||
| FaxNumber: | 9373832916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2018 | ||||||||
| LastUpdateDate: | 04/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S.1800348-TRNE | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.