Provider Demographics
NPI:1992320279
Name:FARBER, CARRIE LYNNE (LMT)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNNE
Last Name:FARBER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:CARRIE
Other - Middle Name:LYNNE
Other - Last Name:MARCIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:304 CONGRESS STREET
Mailing Address - Street 2:
Mailing Address - City:MILLINOCKET
Mailing Address - State:ME
Mailing Address - Zip Code:04462
Mailing Address - Country:US
Mailing Address - Phone:207-570-6964
Mailing Address - Fax:
Practice Address - Street 1:304 BATES STREET
Practice Address - Street 2:
Practice Address - City:MILLINOKET
Practice Address - State:ME
Practice Address - Zip Code:04462
Practice Address - Country:US
Practice Address - Phone:207-570-6964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3997225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist