Healthcare Provider Details

I. General information

NPI: 1598371528
Provider Name (Legal Business Name): ALLISON FARLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SUDBROOK LN STE A
BALTIMORE MD
21208-4184
US

IV. Provider business mailing address

101 BLUEBILL CT
HAVRE DE GRACE MD
21078-4202
US

V. Phone/Fax

Practice location:
  • Phone: 443-918-5575
  • Fax:
Mailing address:
  • Phone: 410-258-5896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number09609
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: