Healthcare Provider Details

I. General information

NPI: 1497932081
Provider Name (Legal Business Name): PATRICIA J LAFAVE P H D & ASSOCIATES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SPRING ARBOR RD SUITE 800
JACKSON MI
49203-8605
US

IV. Provider business mailing address

3333 SPRING ARBOR RD SUITE 800
JACKSON MI
49203-8605
US

V. Phone/Fax

Practice location:
  • Phone: 517-782-2442
  • Fax: 517-782-0310
Mailing address:
  • Phone: 517-782-2442
  • Fax: 517-782-0310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. PATRICIA J LAFAVE
Title or Position: PHD
Credential: PHD
Phone: 517-782-2442