Provider Demographics
NPI:1952010514
Name:FARYNA, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:FARYNA
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:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:NUNN
Mailing Address - State:CO
Mailing Address - Zip Code:80648-0251
Mailing Address - Country:US
Mailing Address - Phone:970-302-1853
Mailing Address - Fax:
Practice Address - Street 1:50585 WCR 21
Practice Address - Street 2:
Practice Address - City:NUNN
Practice Address - State:CO
Practice Address - Zip Code:80648
Practice Address - Country:US
Practice Address - Phone:970-302-1853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician