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General NPI Number Information
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NPI Number | 1013243286
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Entity Type | Individual
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Provider Name | JULIE H LAFONTAINE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/23/2009
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 130 BERTRAND RD
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-6985
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Country | US
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Telephone | 518-606-4360
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Fax |
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Provider Business Mailing Address
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Address Line | 139 BERTRAND RD.
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-6986
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Country | US
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Telephone | 518-573-2333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 012662-1
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License Number State | NY
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