Provider Information for 1558812347
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AMANDA FAVRETTO LMHC, LAC, NCC, CCTP
Sex: Female
NPI: 1558812347
Last Updated: 2016-10-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1558812347 | ||||||||||||
| Enumeration Date | 2016-10-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 11 GARVEY RD WAYNE, NJ 07470-3628 United States Phone: 973-706-6629 | Fax: | ||||||||||||
| Primary Practice Address | 11 GARVEY RD WAYNE, NJ 07470-3628 United States Phone: 973-706-6629 | Fax: | ||||||||||||
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