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General NPI Number Information
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NPI Number | 1316926256
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Entity Type | Individual
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Provider Name | SHIRLEY LAFONT L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 410 TANNER ST
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City | SIKESTON
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State | MO
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Zip | 63801-4273
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Country | US
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Telephone | 573-620-0273
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Fax |
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Provider Business Mailing Address
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Address Line | 917 N RANNEY ST
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City | SIKESTON
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State | MO
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Zip | 63801-5003
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Country | US
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Telephone | 573-620-0273
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 000576
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License Number State | MO
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