Provider Demographics
NPI:1972053841
Name:FARRAR, ASHLEY MONIQUE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MONIQUE
Last Name:FARRAR
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 1:32 HOLYOKE ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5609
Mailing Address - Country:US
Mailing Address - Phone:978-210-7471
Mailing Address - Fax:
Practice Address - Street 1:32 HOLYOKE ST UNIT 1
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5609
Practice Address - Country:US
Practice Address - Phone:978-210-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health