MEDICARE: ANNIE FARMER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	37541	TX

General Provider Information

NPI Number	:	1811428865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE FARMER PH.D.

Provider Business Mailing Address
First Line	:	1907 N LAMAR BLVD
Second Line	:	SUITE 240
City	:	AUSTIN
State	:	TX
Zip	:	78705-4992
Country	:	US
Telephone Number	:	512-541-5385
Fax Number	:

Provider Business Practice Location Address
First Line	:	1907 N LAMAR BLVD
Second Line	:	SUITE 240
City	:	AUSTIN
State	:	TX
Zip	:	78705-4992
Country	:	US
Telephone Number	:	512-541-5385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2017
Last Update Date	:	03/22/2017

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