Provider Information for 1598035834
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KEVIN GREGORY FARRELL LCSW
Sex: Male
NPI: 1598035834
Last Updated: 2012-01-04
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1598035834 | ||||||||
| Enumeration Date | 2012-01-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1626 WESTWOOD BLVD SUITE # 102 LOS ANGELES, CA 90024-5621 United States Phone: 213-973-4416 | Fax:213-973-4416 | ||||||||
| Primary Practice Address | 1626 WESTWOOD BLVD SUITE # 102 LOS ANGELES, CA 90024-5621 United States Phone: 213-973-4416 | Fax:213-973-4416 | ||||||||
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