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1003488958
IRETA FAVORS
ATHENS, GA
NPI
1003488958
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: GA RN296873)
Enumeration Date
2021-07-12
Last Update Date
2024-02-20
Business Address
IRETA FAVORS PMHNP
250 BRAY ST
ATHENS, GA 30601-2203
Phone number: 678-215-4907
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Mailing Address
IRETA FAVORS PMHNP
1575 LAWRENCEVILLE HWY STE K
LAWRENCEVILLE, GA 30044-2007
Phone number: 678-215-4907
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