Individual
IRETA FAVORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
250 BRAY ST, ATHENS, GA 30601-2203
(678) 215-4907
(678) 671-8489
Mailing address
1575 LAWRENCEVILLE HWY STE K, LAWRENCEVILLE, GA 30044-2007
(678) 215-4907
(678) 671-8489
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN296873
GA
Other
Enumeration date
07/12/2021
Last updated
02/20/2024
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