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Individual

MR. ROBERT KEVIN LAFOUNTAIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.S.W., L.C.S.W

Contact information

Practice address
2500 HALL AVE, MARINETTE, WI 54143-1604
(715) 732-7760
Mailing address
N3812 BONEHAM ADDITION RD, MARINETTE, WI 54143-9509
(715) 735-0670

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7110-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40910500
WI
Enumeration date
11/21/2005
Last updated
07/09/2007
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