Individual
CRYSTAL LYNN FAVRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC007028, GEORGIA
Contact information
Practice address
2404 REFUGE RD, JASPER, GA 30143-4946
(706) 692-7209
(706) 693-0144
Mailing address
905 ROCKY RIDGE PASS, CANTON, GA 30114-9751
(404) 786-2040
(770) 345-8801
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/02/2009
Last updated
06/19/2013
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