Provider Demographics
NPI:1568850527
Name:FARRELL, KIRSTEN SIOBHAN (ATC)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:SIOBHAN
Last Name:FARRELL
Suffix:
Gender:F
Credentials:ATC
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Mailing Address - Street 1:8745 DELGANY AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-8175
Mailing Address - Country:US
Mailing Address - Phone:310-384-8214
Mailing Address - Fax:310-823-5668
Practice Address - Street 1:8745 DELGANY AVE APT 103
Practice Address - Street 2:
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-8175
Practice Address - Country:US
Practice Address - Phone:310-384-8214
Practice Address - Fax:310-823-5668
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer