Provider Demographics
NPI:1144666058
Name:FARRELL-TURNER, KRISTEN ANNE (PHD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANNE
Last Name:FARRELL-TURNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANNE
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9250 SW 183RD TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5774
Mailing Address - Country:US
Mailing Address - Phone:216-314-2811
Mailing Address - Fax:
Practice Address - Street 1:7685 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3161
Practice Address - Country:US
Practice Address - Phone:216-314-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical