Provider Demographics
NPI:1568218592
Name:FARR, ELIZABETH MARGARET (LMT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARGARET
Last Name:FARR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 MADEIRA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5140
Mailing Address - Country:US
Mailing Address - Phone:505-249-6305
Mailing Address - Fax:
Practice Address - Street 1:921 VALENCIA DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1753
Practice Address - Country:US
Practice Address - Phone:505-615-4884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5687225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist