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General NPI Number Information
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NPI Number | 1811221914
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Entity Type | Organization
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Legal Business Name | BONNIE J. FARR, PSYD, PA
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 3002 SE 1ST AVE BUILDING 200
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City | OCALA
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State | FL
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Zip | 34471-0477
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Country | US
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Telephone | 352-209-8649
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Fax | 352-486-7884
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Provider Business Mailing Address
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Address Line | 3002 SE 1ST AVE BUILDING 200
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City | OCALA
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State | FL
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Zip | 34471-0477
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Country | US
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Telephone | 352-209-8649
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Fax | 352-486-7884
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Authorized Official
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Title or Position | CEO
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Name | DR. BONNIE J FARR
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Credential | PSYD
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Telephone | 352-209-8649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY 7147
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License Number State | FL
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