Individual provider · NPI-1

Si'Ara Washington Farris, ATC, LMT

Specialist/Technologist, Athletic Trainer · Lithonia, GA

NPI number1205442472
StatusActive
Last updated in NPPESSep 22, 2020

Details

NPI
1205442472
Entity type
Individual (NPI-1)
Name
Si'Ara Washington Farris
Credential
ATC, LMT
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 22, 2020
Certification date
Sep 22, 2020
Last updated
Sep 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic TrainerAT003870GAYes
225700000X Massage Therapist9454SC
2255A2300X Specialist/Technologist, Athletic Trainer1418SC

Other names

  • Si'Ara Shalai Washington (Former Name)

Practice location

564 Hillandale Park Dr
Lithonia, GA 30058-8833

Phone 843-718-7536

Mailing address

564 Hillandale Park Dr
Lithonia, GA 30058-8833

Phone 843-718-7536

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Specialist/Technologist, Athletic Trainer providers in Lithonia, GA