Individual
JEAN FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
540 W MAIN ST, WYTHEVILLE, VA 24382-2209
(276) 223-3206
Mailing address
770 W RIDGE RD, WYTHEVILLE, VA 24382-1187
(276) 223-3206
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001260
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133001260
DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
03/06/2019
Last updated
10/13/2023
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