Individual
ROSE MARY FAVRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
215 KATHERINE DR STE A, FLOWOOD, MS 39232-9588
(601) 665-4162
(855) 830-3484
Mailing address
505 DEMONTLUZIN AVE, BAY ST LOUIS, MS 39520-3505
(228) 304-0446
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7379
MS
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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