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Individual

DEWAYNIA TRANIESE FARROW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1709 BUNKER HILL RD, COLUMBUS, GA 31907-6719
(334) 524-1809
Mailing address
130 CORRIDOR RD UNIT 3292, PONTE VEDRA BEACH, FL 32004-7833
(334) 524-1809
(904) 485-8829

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NA
AL
Enumeration date
07/12/2019
Last updated
07/12/2019
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