MEDICARE: DR. ALICE F FARMER PHD

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

General Provider Information

NPI Number	:	1861745804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICE F FARMER PHD

Provider Business Mailing Address
First Line	:	4 E MAIN ST
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2720
Country	:	US
Telephone Number	:	276-224-6328
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 E MAIN ST
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2720
Country	:	US
Telephone Number	:	276-224-6328
Fax Number	:

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

Provider Enumeration Date	:	10/15/2012
Last Update Date	:	10/15/2012

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