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General NPI Number Information
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NPI Number | 1265289201
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Entity Type | Individual
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Provider Name | ALI FARHAN
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Gender | Male
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 4638 W ALTA VISTA RD
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City | LAVEEN
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State | AZ
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Zip | 85339-1930
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Country | US
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Telephone | 605-824-8659
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Fax |
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Provider Business Mailing Address
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Address Line | 10873 W DEVONSHIRE AVE
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City | PHOENIX
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State | AZ
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Zip | 85037-5760
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | AZ
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