Tom Favreau, QMHP, MA
NPI #1306997481 in Cottage Grove, Oregon
Provider Information
- NPI Number
- 1306997481
- Entity Type
- Individual
- Name
- Tom Favreau, QMHP, MA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Credential
- QMHP, MA
- Enumeration Date
- Jan 15, 2007
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 410 N 9TH ST
- City
- Cottage Grove
- State
- Oregon
- ZIP Code
- 97424-1307
- Phone
- (541) 942-2850
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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