Provider Demographics
NPI:1174766646
Name:WILLIAM FAVRET & ASSOCIATES
Entity type:Organization
Organization Name:WILLIAM FAVRET & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RAOUL
Authorized Official - Last Name:FAVRET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-525-8081
Mailing Address - Street 1:1892 ASHEMONT RD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-7317
Mailing Address - Country:US
Mailing Address - Phone:910-525-8081
Mailing Address - Fax:
Practice Address - Street 1:1892 ASHEMONT RD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-7317
Practice Address - Country:US
Practice Address - Phone:910-525-8081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1563103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty