MEDICARE: ANNA LAFOND

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
1	174400000X	Specialist	293661	OR
2	225X00000X	Occupational Therapist		OH
3	225X00000X	Occupational Therapist	OT.008087	OH

General Provider Information

NPI Number	:	1669730891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA LAFOND

Provider Business Mailing Address
First Line	:	3501 BOYNTON RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 BOYNTON RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1516
Country	:	US
Telephone Number	:	360-888-3083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	10/16/2012

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Directions to “ ANNA LAFOND ” Practice Location

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