Provider Demographics
NPI:1811605629
Name:FARROW, NIA NOELLE
Entity type:Individual
Prefix:
First Name:NIA
Middle Name:NOELLE
Last Name:FARROW
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 1:4220 RIVER BIRCH LOOP APT 3A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9284
Mailing Address - Country:US
Mailing Address - Phone:336-420-4671
Mailing Address - Fax:
Practice Address - Street 1:4220 RIVER BIRCH LOOP APT 3A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9284
Practice Address - Country:US
Practice Address - Phone:336-420-4671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst