Healthcare Provider Details

I. General information

NPI: 1710825666
Provider Name (Legal Business Name): CARRIE L. FARR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 W FRONT ST
ALBERT LEA MN
56007-1811
US

IV. Provider business mailing address

13345 750TH ST
BLOOMING PRAIRIE MN
55917-6960
US

V. Phone/Fax

Practice location:
  • Phone: 507-379-5283
  • Fax:
Mailing address:
  • Phone: 507-379-5283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number17221
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: