Individual
MRS. AMY MARIE FARMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
7704 DEERPATH RD, CHARLESTON, IL 61920-8735
(217) 508-7171
Mailing address
2506 BUXTON DR, APT 116, MATTOON, IL 61938-9293
(217) 317-1587
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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