Provider Demographics
NPI:1962627323
Name:FARMER, MELISSA (BS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3440 NEW HARTFORD RD
Mailing Address - Street 2:APT 9
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4627
Mailing Address - Country:US
Mailing Address - Phone:812-431-2088
Mailing Address - Fax:
Practice Address - Street 1:1510 W FRANKLIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1032
Practice Address - Country:US
Practice Address - Phone:812-424-0223
Practice Address - Fax:812-424-0226
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)