Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | C02376 | MI |
N | 101YM0800X | Mental Health Counselor | 318674 | MI |
Y | 101YP2500X | Professional Counselor | 6401012447 | MI |
N | 225C00000X | Rehabilitation Counselor | 00049518 | MI |
N | 225X00000X | Occupational Therapist | 5201000678 | MI |
NPI | 1174941157 |
---|---|
Provider Name | Dr. Debra J. Farrell |
First Address | Lansing, MI 48917-8266 |
Second Address | Lansing, MI 48917-8266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 24/03/2018 |