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General NPI Number Information
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NPI Number | 1447548862
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Entity Type | Individual
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Provider Name | JENNIFER FLOREN FARMER LPC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 4180 PROVIDENCE RD SUITE 107
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City | MARIETTA
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State | GA
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Zip | 30062-6186
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Country | US
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Telephone | 678-819-2596
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 WINSORBROOK DRIVE
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City | MARIETTA
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State | GA
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Zip | 30062
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Country | US
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Telephone | 770-321-5515
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 002353
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License Number State | GA
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