Provider Demographics
NPI:1477844066
Name:FARR, ASHLEY (LAC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 SOUTHPORT DR
Mailing Address - Street 2:APT. A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6828
Mailing Address - Country:US
Mailing Address - Phone:512-680-3802
Mailing Address - Fax:
Practice Address - Street 1:1532 SOUTHPORT DR
Practice Address - Street 2:APT. A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6828
Practice Address - Country:US
Practice Address - Phone:512-680-3802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01197171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist