Provider Demographics
NPI:1669055992
Name:SCARLETT, FARYN
Entity type:Individual
Prefix:
First Name:FARYN
Middle Name:
Last Name:SCARLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 PRAIRIE
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1756
Mailing Address - Country:US
Mailing Address - Phone:248-884-6715
Mailing Address - Fax:
Practice Address - Street 1:339 PRAIRIE
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-1756
Practice Address - Country:US
Practice Address - Phone:248-884-6715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool