Provider Demographics
NPI:1013409705
Name:FARKAS, MARIANNE DAISY (SCD)
Entity Type:Individual
Prefix:PROF
First Name:MARIANNE
Middle Name:DAISY
Last Name:FARKAS
Suffix:
Gender:F
Credentials:SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 KENDALL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7143
Mailing Address - Country:US
Mailing Address - Phone:781-861-6840
Mailing Address - Fax:
Practice Address - Street 1:18 KENDALL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7143
Practice Address - Country:US
Practice Address - Phone:781-861-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2877103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist