Provider Demographics
NPI:1891225777
Name:FERCHA, BADYR
Entity Type:Individual
Prefix:
First Name:BADYR
Middle Name:
Last Name:FERCHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 W CLYDE PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2721
Mailing Address - Country:US
Mailing Address - Phone:509-998-4303
Mailing Address - Fax:
Practice Address - Street 1:3144 W CLYDE PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2721
Practice Address - Country:US
Practice Address - Phone:509-998-4303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health