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Individual

DR. PATRICIA J LAFAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3333 SPRING ARBOR RD, SUITE 800, JACKSON, MI 49203-8605
(517) 782-2442
(517) 782-0310
Mailing address
6602 LAKESHORE RD, BURTCHVILLE, MI 48059-2213
(810) 385-4953

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301002176
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007058
VO
01
0C845090
BC
01
150619000
MAG
Enumeration date
08/25/2005
Last updated
09/28/2011
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