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Individual

ITHACA L. FAVOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
882 PLANTATION WAY STE E, MONTGOMERY, AL 36117-2217
(334) 604-3932
Mailing address
6617 CONCORD MEWS, MONTGOMERY, AL 36116-5293
(334) 604-3932

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C3455A
AL
101YP2500X
Professional Counselor
Primary
LPC04612
AL

Other

Enumeration date
03/01/2020
Last updated
10/16/2023
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