Provider Demographics
NPI:1750928032
Name:FARR, MELANIE (LCDC I)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:LCDC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 SPENCER LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-2030
Mailing Address - Country:US
Mailing Address - Phone:210-736-4405
Mailing Address - Fax:210-736-4407
Practice Address - Street 1:571 SPENCER LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2030
Practice Address - Country:US
Practice Address - Phone:210-736-4405
Practice Address - Fax:210-736-4407
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)