Provider Demographics
NPI:1578152948
Name:FARHANG, SHEENA (MA)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:FARHANG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N ORACLE RD STE 411
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7734
Mailing Address - Country:US
Mailing Address - Phone:520-200-5190
Mailing Address - Fax:
Practice Address - Street 1:6700 N ORACLE RD STE 412
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7734
Practice Address - Country:US
Practice Address - Phone:520-200-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty