Provider Demographics
NPI:1578346870
Name:FARNUM, ANNA GRACE HWAN HEE
Entity Type:Individual
Prefix:
First Name:ANNA GRACE
Middle Name:HWAN HEE
Last Name:FARNUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32869 WATCHTOWER DR
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-4277
Mailing Address - Country:US
Mailing Address - Phone:443-991-9195
Mailing Address - Fax:
Practice Address - Street 1:9970 S. CENTRAL PARK BOULEVARD
Practice Address - Street 2:SUITE 401
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428
Practice Address - Country:US
Practice Address - Phone:305-807-1909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst