MEDICARE: TERRI FARNER M.S.

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	222Q00000X	Developmental Therapist	SA 13610	FL

General Provider Information

NPI Number	:	1962957746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI FARNER M.S.

Provider Business Mailing Address
First Line	:	1834 SW 21ST ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-1833
Country	:	US
Telephone Number	:	559-380-5296
Fax Number	:

Provider Business Practice Location Address
First Line	:	1834 SW 21ST ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-1833
Country	:	US
Telephone Number	:	559-380-5296
Fax Number	:

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

Provider Enumeration Date	:	08/22/2016
Last Update Date	:	09/07/2016

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Directions to “ TERRI FARNER M.S.” Practice Location

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