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Individual

NICHOLE M FAVAZZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
59 DANBURY RD, WILTON, CT 06897-4405
(203) 210-7124
Mailing address
115 WOLFS LN APT 3, PELHAM, NY 10803-1839
(914) 714-1187

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
657
CT

Other

Enumeration date
09/20/2018
Last updated
09/20/2018
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