| NPI | 1982079091 |
|---|---|
| Doing Business As | IEISHA FARRELL |
| Entity Type | Organization |
| Authorized Contact | IEISHA T FARRELL Solo Provider 850-445-8821 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |