Individual
MRS. BRENDA JANE FAVERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,C.C.C.,L.S.P.
Contact information
Practice address
29 PINEWOOD DR, COMMACK, NY 11725-5612
(631) 499-1237
Mailing address
74 NEW MILL RD, SMITHTOWN, NY 11787-3350
(631) 979-2089
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
007221-1
NY
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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