Individual
MS. ANITA LAFOLLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
35 MARIA DR STE 863, PETALUMA, CA 94954-3548
(707) 774-4888
Mailing address
16A WEST ST, PETALUMA, CA 94952-2110
(707) 774-4888
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MFT44510
CA
Other
Enumeration date
01/03/2014
Last updated
01/08/2014
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