Provider Demographics
NPI:1043095433
Name:FARNHAM, AUDREY (CF-SLP)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:FARNHAM
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3948 GRANITE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2185
Mailing Address - Country:US
Mailing Address - Phone:314-779-4372
Mailing Address - Fax:
Practice Address - Street 1:1910 WHITENER ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-5239
Practice Address - Country:US
Practice Address - Phone:573-334-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist