Individual
MRS. STEPHANIE G FAVORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
701 22ND ST, PHENIX CITY, AL 36867-4663
(334) 298-3401
Mailing address
6298 VETERANS PKWY, SUITE 5A, COLUMBUS, GA 31909-6258
(706) 322-7762
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4103
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4103
OT LICENSE
GA
Enumeration date
06/26/2006
Last updated
07/26/2007
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