Individual
MS. AMY ANN LAFAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
926 WILLARD DR, SUITE 114, GREEN BAY, WI 54304
(920) 592-9330
(920) 592-9320
Mailing address
1129 BROOKWOOD DR, GREEN BAY, WI 54304
(920) 490-4677
(920) 592-9320
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1635154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42754500
—
WI
Enumeration date
12/06/2006
Last updated
07/08/2007
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