Doctor Name: | CRYSTAL LYNN FAVRE |
NPI Number: | 1619202041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC007028, GEORGIA |
License Number: | |
Business Practice Address: | 2404 Refuge Rd Jasper, GA - 301434946 |
Business Phone Number: | 7066927209 |
Business Fax Number: | 7066930144 |
Mailing Address: | 905 Rocky Ridge Pass, CANTON |
State: | GA |
Postal Code: | 301149751 |
Phone Number: | 4047862040 |
Fax Number: | 7703458801 |
NPI Enumeration Date: | 10/02/2009 |
NPI Last Update Date: | 06/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |