Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 99133 | CA |
NPI | 1003016635 |
---|---|
Provider Name | Miss Lillian P Farrah |
First Address | Los Angeles, CA 90042-1678 |
Second Address | Los Angeles, CA 90020-1912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2007 |
Last Update Date | 24/03/2021 |