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Individual

DR. LAUREN RENEE FAVREAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DAC, LAC

Contact information

Practice address
60 PINELAND DR STE 203, NEW GLOUCESTER, ME 04260-5121
(207) 808-9174
Mailing address
320 WINDHAM CENTER RD, WINDHAM, ME 04062-4339
(914) 494-5236

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC576
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
167026
NCCAOM (NATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE & ORIENTAL MEDICINE)
Enumeration date
06/21/2017
Last updated
08/10/2022
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