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General NPI Number Information
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NPI Number | 1043466436
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Entity Type | Individual
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Provider Name | MICHAEL J LAFARR JR. PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 415 SOUTH ST COUNSELING CENTER, BRANDEIS UNIVERSITY
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City | WALTHAM
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State | MA
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Zip | 02453-2728
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Country | US
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Telephone | 781-736-3543
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Fax |
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Provider Business Mailing Address
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Address Line | 415 SOUTH ST COUNSELING CENTER, BRANDEIS UNIVERSITY
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City | WALTHAM
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State | MA
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Zip | 02453-2728
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Country | US
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Telephone | 781-736-3543
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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