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General NPI Number Information
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NPI Number | 1174766646
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Entity Type | Organization
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Legal Business Name | WILLIAM FAVRET & ASSOCIATES
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 1892 ASHEMONT RD
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City | ABERDEEN
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State | NC
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Zip | 28315-7317
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Country | US
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Telephone | 910-525-8081
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Fax |
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Provider Business Mailing Address
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Address Line | 1892 ASHEMONT RD
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City | ABERDEEN
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State | NC
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Zip | 28315-7317
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Country | US
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Telephone | 910-525-8081
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM RAOUL FAVRET
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Credential |
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Telephone | 910-525-8081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1563
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License Number State | NC
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