Individual
TRAVIS FARRAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
79 MECHANICS ST APT 2, PUTNAM, CT 06260-1318
(774) 601-3258
Mailing address
79 MECHANICS ST APT 2, PUTNAM, CT 06260-1318
(774) 230-1082
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
174400000X
Specialist
HYP.0000531
CT
Other
Enumeration date
08/20/2021
Last updated
09/28/2023
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