Provider Demographics
NPI:1861026817
Name:FARRENS, CIERA (RBT)
Entity Type:Individual
Prefix:
First Name:CIERA
Middle Name:
Last Name:FARRENS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 E GREGORY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1117
Mailing Address - Country:US
Mailing Address - Phone:816-474-2995
Mailing Address - Fax:
Practice Address - Street 1:7 E GREGORY BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1117
Practice Address - Country:US
Practice Address - Phone:816-474-2995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO19-78949106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician