Individual
MS. MARISSA ETHRIDGE FARQUHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4735 OLD CANTON RD STE 111, JACKSON, MS 39211-5500
(601) 479-3397
Mailing address
50 SUMMIT RIDGE DR, BRANDON, MS 39042-2503
(601) 479-3397
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M9392
MS
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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