Individual
NICHOLAS R FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34700 VALLEY RD, OCONOMOWOC, WI 53066-4500
(800) 767-4411
(262) 646-3158
Mailing address
34700 VALLEY RD, OCONOMOWOC, WI 53066-4500
(800) 767-4411
(262) 646-1049
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3525
WI
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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