Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA FAVREAU, ATC
ActiveLISA FAVREAU, ATC is a Athletic Trainer healthcare provider located in SO PORTLAND, Maine. NPI 1497790836 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · SO PORTLAND, ME
Registration Details
- NPI Number
- 1497790836
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 19, 2006 (20.111347148198 yrs)
- Last Updated
- Jul 8, 2007
- License
-
AT263 (ME)
Practice Information
- Address
-
100 FODEN RDSUITE 103WSO PORTLAND, ME, 041062319Browse ME providers · Browse ZIP 04106
- Phone
- 2077722625
- Fax
- 2078794246
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.