Provider Demographics
NPI:1235853995
Name:FARMER, FALYN (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:FALYN
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5698 HIGHWAY 177 S
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72519-9710
Mailing Address - Country:US
Mailing Address - Phone:870-421-2919
Mailing Address - Fax:
Practice Address - Street 1:1100 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2029
Practice Address - Country:US
Practice Address - Phone:417-257-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022036107225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist