MEDICARE: MRS. BRITTANY FARROW LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	02186-I	NV
2	106H00000X	Marriage & Family Therapist	2925	NV
3	106H00000X	Marriage & Family Therapist	MI0896	NV

General Provider Information

NPI Number	:	1073036463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRITTANY FARROW LMFT

Provider Business Mailing Address
First Line	:	9480 S EASTERN AVE STE 241
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8037
Country	:	US
Telephone Number	:	702-701-1530
Fax Number	:	702-628-9771

Provider Business Practice Location Address
First Line	:	9480 S EASTERN AVE STE 241
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8037
Country	:	US
Telephone Number	:	702-701-1530
Fax Number	:	702-628-9771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2017
Last Update Date	:	09/28/2020

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