| NPI | 1891793758 |
|---|---|
| Former Name | STACY FARNHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 40626) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO R5N62) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2018-08-28 |