Provider Demographics
NPI:1770738940
Name:FARCHIONE, DONNA H (MS, CCC-SLP, LMFT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:H
Last Name:FARCHIONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 EAGLE CREST DR
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-9694
Mailing Address - Country:US
Mailing Address - Phone:315-263-6304
Mailing Address - Fax:
Practice Address - Street 1:5700 W GENESEE ST
Practice Address - Street 2:SUITE 124
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-3200
Practice Address - Country:US
Practice Address - Phone:315-263-6304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011074235Z00000X
NY001242106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist