Individual
EVA FAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
179 S MAPLE AVE, RIDGEWOOD, NJ 07450-4541
(551) 252-5270
Mailing address
322 LIVINGSTON AVE, LYNDHURST, NJ 07071-2103
(201) 978-6198
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00663800
NJ
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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