MEDICARE: JOSEPHINE FARLEY

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1881392702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE FARLEY

Provider Business Mailing Address
First Line	:	6767 W WINDMILL LN APT 2088
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6509
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6767 W WINDMILL LN APT 2088
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6509
Country	:	US
Telephone Number	:	805-210-1027
Fax Number	:

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

Provider Enumeration Date	:	02/20/2023
Last Update Date	:	02/20/2023

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Directions to “ JOSEPHINE FARLEY ” Practice Location

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