Individual
JACLYN FAVALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 CATOCTIN CIR NE, LEESBURG, VA 20176-4964
(347) 556-3920
Mailing address
60 CHATWELL TER, CHARLES TOWN, WV 25414-1212
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010106
VA
235Z00000X
Speech-Language Pathologist
—
NY
Other
Enumeration date
06/11/2020
Last updated
07/18/2022
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