Jaclyn Favale
Speech-Language Pathologist, in Leesburg, VA. Individual provider (NPI-1).
NPI number1336764786
StatusActive
Last updated in NPPESJul 18, 2022
Details
- NPI
- 1336764786
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn Favale
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 11, 2020
- Certification date
- Jul 18, 2022
- Last updated
- Jul 18, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 2202010106 | VA | Yes |
| 235Z00000X | Speech-Language Pathologist, | – | NY |
Practice location
601 Catoctin Cir NeLeesburg, VA 20176-4964
Phone 347-556-3920
Mailing address
60 Chatwell TerCharles Town, WV 25414-1212
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All 52 Speech-Language Pathologist providers in Leesburg · All 2,386 providers in Leesburg
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