Individual
JOHN WILLIAM LAFOLLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, MATS
Contact information
Practice address
2374 SHAKER LN APT E, LEBANON, IN 46052-4100
(317) 797-0773
Mailing address
4705 MEIJER CT, LAFAYETTE, IN 47905-4684
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
86000408A
IN
Other
Enumeration date
05/05/2022
Last updated
11/30/2022
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