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NPI Code Detail

MEDICARE: MAEGEN R LAFONTAINE

MEDICARE: MAEGEN R LAFONTAINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianMN

General Provider Information

NPI Number : 1316896061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAEGEN R LAFONTAINE
Provider Business Mailing Address
First Line : 3333 UNIVERSITY AVE SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3325
Country : US
Telephone Number : 612-331-9413
Fax Number :
Provider Business Practice Location Address
First Line : 3333 UNIVERSITY AVE SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3325
Country : US
Telephone Number : 612-331-9413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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Directions to “ MAEGEN R LAFONTAINE ” Practice Location

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