Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 9739455 | AZ |
NPI | 1003389065 |
---|---|
Provider Name | Janet Carol Farmer |
First Address | Phoenix, AZ 85011-6906 |
Second Address | Goodyear, AZ 85395-8410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2019 |
Last Update Date | 02/01/2019 |