Provider Demographics
NPI:1639068661
Name:FARRELL, DENISE (PHD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-2124
Mailing Address - Country:US
Mailing Address - Phone:615-593-7189
Mailing Address - Fax:
Practice Address - Street 1:1801 SW 1ST AVE APT 410
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-2155
Practice Address - Country:US
Practice Address - Phone:615-593-7189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach