| Doctor Name: | JAMES FAVRET |
| NPI Number: | 1578538807 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 03346 |
| Business Practice Address: | 79 Mdos Sgoh 1050 W. Perimeter Rd Andrews Afb, MD - 20762 |
| Business Phone Number: | 2408579944 |
| Business Fax Number: | |
| Mailing Address: | 11 German St, ANNAPOLIS |
| State: | MD |
| Postal Code: | 214013514 |
| Phone Number: | 4102679646 |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 03346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |