Provider Demographics
NPI:1073332698
Name:FARR, KERRY (BCBA)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 E 500 S UNIT A
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2995
Mailing Address - Country:US
Mailing Address - Phone:435-754-6560
Mailing Address - Fax:
Practice Address - Street 1:747 E 500 S UNIT A
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2995
Practice Address - Country:US
Practice Address - Phone:435-754-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11672488-2506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst