Jill C Favata, M.S. ED, LPC

NPI #1972587319 in Cheyenne, Wyoming

Provider Information

NPI Number: 1972587319
Entity Type: Individual
Name: Jill C Favata, M.S. ED, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: M.S. ED, LPC
Enumeration Date: Nov 30, 2005
Last Updated: Jun 30, 2009

Practice Location

Address: 2909 BENT AVE
Address 2: THE HEALING CENTER
City: Cheyenne
State: Wyoming
ZIP Code: 82001-2742
Phone: (307) 286-5279

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor	101Y00000X	Primary

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