Individual
SHAWNA ANNIE MICHELLE FARRAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
6012 REEF POINT LN STE C, FORT WORTH, TX 76135-2056
(918) 782-8164
Mailing address
812 IRONSIDES LN, BLUE MOUND, TX 76131-1532
(918) 782-8164
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
95460
TX
Other
Enumeration date
07/22/2024
Last updated
08/16/2024
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