Provider Demographics
NPI:1699293191
Name:FARROW, ALYSSA
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:FARROW
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 1:7400 N LAMAR BLVD APT 1503
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-2474
Mailing Address - Country:US
Mailing Address - Phone:254-718-1117
Mailing Address - Fax:
Practice Address - Street 1:13215 RAMPART ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-3255
Practice Address - Country:US
Practice Address - Phone:512-843-1453
Practice Address - Fax:512-532-9565
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118581225X00000X
TX225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist