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General NPI Number Information
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NPI Number | 1518859941
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Entity Type | Individual
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Provider Name | MS. KEVONNE FARQUHARSON
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Gender |
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 3251 ENGINEERING ST
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City | MELBOURNE
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State | FL
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Zip | 32901
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Country | US
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Telephone | 321-674-8106
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Fax |
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Provider Business Mailing Address
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Address Line | 4580 AMORE LN UNIT 101
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City | MELBOURNE
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State | FL
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Zip | 32904-8519
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Country | US
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Telephone | 321-487-5771
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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