Individual
HEATHER FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.T.
Contact information
Practice address
3821 ATLANTIC AVE, SUITE F, LONG BEACH, CA 90807-3534
(562) 940-5450
(562) 424-3235
Mailing address
3821 ATLANTIC AVE, SUITE F, LONG BEACH, CA 90807-3534
(562) 940-5450
(562) 424-3235
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
68134
CA
174400000X
Specialist
68134
CA
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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