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NPI Code Detail

MEDICARE: MRS. NICOLE FARNELL M.ED.

MEDICARE: MRS. NICOLE FARNELL M.ED.
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
1103T00000XPsychologistOH3008644OH

General Provider Information

NPI Number : 1326440330
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE FARNELL M.ED.
Provider Business Mailing Address
First Line : 2011 TIMBER LN
Second Line :
City : DAYTON
State : OH
Zip : 45414-4528
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2011 TIMBER LN
Second Line :
City : DAYTON
State : OH
Zip : 45414-4528
Country : US
Telephone Number : 937-278-5885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2014
Last Update Date : 09/22/2014

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