Provider Demographics
NPI:1477706521
Name:CHRISTIAN, KATHY FARNEN (CCC-SP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:FARNEN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:CCC-SP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHRYN
Other - Last Name:FARNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:293 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3910
Mailing Address - Country:US
Mailing Address - Phone:718-768-2723
Mailing Address - Fax:718-680-7977
Practice Address - Street 1:420 95TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7404
Practice Address - Country:US
Practice Address - Phone:718-680-9751
Practice Address - Fax:718-680-7977
Is Sole Proprietor?:No
Enumeration Date:2008-11-01
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002181-1235Z00000X
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174400000XOther Service ProvidersSpecialist