Provider Demographics
NPI:1194367433
Name:FARMER, MYRIAH (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MYRIAH
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 LIONS HEALTH CAMP RD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-8787
Mailing Address - Country:US
Mailing Address - Phone:724-859-9577
Mailing Address - Fax:
Practice Address - Street 1:1285 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-1396
Practice Address - Country:US
Practice Address - Phone:240-236-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist