MEDICARE: SARITHA LATRICE FARRIS

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	1041C0700X	Clinical Social Worker	7448-C	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194029785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARITHA LATRICE FARRIS

Provider Business Mailing Address
First Line	:	PO BOX 82335
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89180-2335
Country	:	US
Telephone Number	:	702-886-0961
Fax Number	:

Provider Business Practice Location Address
First Line	:	7351 W CHARLESTON BLVD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1572
Country	:	US
Telephone Number	:	702-886-0961
Fax Number	:

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

Provider Enumeration Date	:	12/22/2010
Last Update Date	:	03/18/2019

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Directions to “ SARITHA LATRICE FARRIS ” Practice Location

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