Provider Demographics
NPI:1760771992
Name:FARRELL, EVELYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 N MILLER RD STE 110-11
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3619
Mailing Address - Country:US
Mailing Address - Phone:480-442-4564
Mailing Address - Fax:
Practice Address - Street 1:4300 N MILLER RD STE 110-11
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3619
Practice Address - Country:US
Practice Address - Phone:480-442-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4811103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical