Provider Demographics
NPI:1497920599
Name:FARBER, TRACY LINDH (MA, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LINDH
Last Name:FARBER
Suffix:
Gender:F
Credentials:MA, PHARMD
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LINDH
Other - Last Name:UTELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:173 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9367
Mailing Address - Country:US
Mailing Address - Phone:610-473-3204
Mailing Address - Fax:
Practice Address - Street 1:173 HOLLY RD
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9367
Practice Address - Country:US
Practice Address - Phone:610-473-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PARP445584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health