Individual
EDITH FAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1659 S HIGHWAY 65 82, LAKE VILLAGE, AR 71653-1661
(870) 265-4191
Mailing address
PO BOX 1052, GREENVILLE, MS 38702-1052
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#3282
AR
Other
Enumeration date
10/08/2015
Last updated
09/27/2016
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