Individual
LYDIA FARMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
606 E BALTIMORE PIKE FL 2, MEDIA, PA 19063-1751
(610) 864-7376
(877) 599-3340
Mailing address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH005065
PA
106S00000X
Behavior Technician
RBT-16-27066
PA
Other
Enumeration date
02/18/2020
Last updated
10/01/2020
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