Provider Demographics
NPI:1346300647
Name:HARRIET LAFACE M.S.ED., P.A.
Entity Type:Organization
Organization Name:HARRIET LAFACE M.S.ED., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:H
Authorized Official - Last Name:LAFACE
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:407-896-7221
Mailing Address - Street 1:1615 WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4172
Mailing Address - Country:US
Mailing Address - Phone:407-896-7221
Mailing Address - Fax:407-896-9670
Practice Address - Street 1:1615 WOODWARD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4172
Practice Address - Country:US
Practice Address - Phone:407-896-7221
Practice Address - Fax:407-896-9670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMFT958106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty