Individual
MARK LA FAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3900 W BROWN DEER RD STE 200, BROWN DEER, WI 53209-1220
(414) 540-2170
Mailing address
3900 W BROWN DEER RD STE 200, BROWN DEER, WI 53209-1220
(414) 540-2170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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