Individual
LAUREN LEE FAVREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
6506 LOISDALE RD, SPRINGFIELD, VA 22150-1824
(703) 924-4100
Mailing address
4741 W CHERYL DR, JACKSON, MS 39211-5813
(601) 906-2078
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005793
VA
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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