Provider Demographics
NPI:1699127530
Name:FARR, DANA (PHD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SILHOUETTE DR
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06021-1123
Mailing Address - Country:US
Mailing Address - Phone:203-464-3332
Mailing Address - Fax:
Practice Address - Street 1:7 RIVER ST
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3156
Practice Address - Country:US
Practice Address - Phone:860-841-8414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-04
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003857103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist