Provider Demographics
NPI:1093901555
Name:LAFAIR, SYLVIA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:L
Last Name:LAFAIR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 COUNTRY PLACE LANE
Mailing Address - Street 2:
Mailing Address - City:WHITE HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:18661
Mailing Address - Country:US
Mailing Address - Phone:570-636-3858
Mailing Address - Fax:570-636-5387
Practice Address - Street 1:45 COUNTRY PLACE LANE
Practice Address - Street 2:
Practice Address - City:WHITE HAVEN
Practice Address - State:PA
Practice Address - Zip Code:18661
Practice Address - Country:US
Practice Address - Phone:570-636-3858
Practice Address - Fax:570-636-5387
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS001875L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist