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General NPI Number Information
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NPI Number | 1174761217
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Entity Type | Individual
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Provider Name | DEANANN FARRIS D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 110 CAMPUS DR
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City | BRADFORD
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State | PA
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Zip | 16701-1982
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Country | US
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Telephone | 814-362-6535
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Fax | 814-817-2113
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Provider Business Mailing Address
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Address Line | 110 CAMPUS DR
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City | BRADFORD
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State | PA
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Zip | 16701-1982
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Country | US
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Telephone | 814-362-6535
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Fax | 814-817-2113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OT012801
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 3554
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License Number State | WV
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