Provider Demographics
NPI:1629242243
Name:FARRAR, JOEL EDINGTON (MED, CCC-SLP, BCBA)
Entity Type:Individual
Prefix:MS
First Name:JOEL
Middle Name:EDINGTON
Last Name:FARRAR
Suffix:
Gender:F
Credentials:MED, CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 COLBY DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-5567
Mailing Address - Country:US
Mailing Address - Phone:918-637-5114
Mailing Address - Fax:
Practice Address - Street 1:1336 COLBY DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-5567
Practice Address - Country:US
Practice Address - Phone:918-637-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2532235Z00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist