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General NPI Number Information
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NPI Number | 1386506228
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Entity Type | Individual
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Provider Name | MACKENZIE R FARMER
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 9994 SOWDER VILLAGE SQ # 102
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City | MANASSAS
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State | VA
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Zip | 20109-5464
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Country | US
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Telephone | 855-832-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 10123 CHESWICK CT
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City | MANASSAS
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State | VA
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Zip | 20110-6076
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Country | US
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Telephone | 703-479-9926
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State | VA
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