Provider Demographics
NPI:1760920383
Name:FARMER, EILEEN DUFFY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:DUFFY
Last Name:FARMER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:ELIZABETH
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:738 LONG BRIDGE ST APT 412
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2461
Mailing Address - Country:US
Mailing Address - Phone:847-757-2178
Mailing Address - Fax:
Practice Address - Street 1:901 CASTRO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3209
Practice Address - Country:US
Practice Address - Phone:415-255-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist