Provider Demographics
NPI:1760660807
Name:FARNSWORTH, CORRIAN ELIZABETH (MSSP)
Entity Type:Individual
Prefix:MS
First Name:CORRIAN
Middle Name:ELIZABETH
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:MSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SCHOOL ST # 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1722
Mailing Address - Country:US
Mailing Address - Phone:408-406-7646
Mailing Address - Fax:
Practice Address - Street 1:90 LINDALL ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2125
Practice Address - Country:US
Practice Address - Phone:978-777-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist