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NPI Code Detail

MEDICARE: HANNAH LAFONTAINE BCBA

MEDICARE: HANNAH LAFONTAINE BCBA
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
1103K00000XBehavior Analyst1-17-28251

General Provider Information

NPI Number : 1700384187
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH LAFONTAINE BCBA
Provider Business Mailing Address
First Line : 3917 RESEARCH PARK DR STE B-1A
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-2229
Country : US
Telephone Number : 888-754-0398
Fax Number : 954-982-6491
Provider Business Practice Location Address
First Line : 3917 RESEARCH PARK DR STE B-1A
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-2229
Country : US
Telephone Number : 734-794-2930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 09/13/2023

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