Tom Favreau, QMHP, MA
Counselor, Mental Health in Cottage Grove, OR. Individual provider (NPI-1).
NPI number1306997481
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1306997481
- Entity type
- Individual (NPI-1)
- Name
- Tom Favreau
- Credential
- QMHP, MA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2007
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
410 N 9th StCottage Grove, OR 97424-1307
Phone 541-942-2850 · Fax 541-942-1574
Mailing address
410 N 9th StCottage Grove, OR 97424-1307
Phone 541-942-2850 · Fax 541-942-1574
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