Provider Demographics
NPI:1508103391
Name:JARING, LAFONDRA CECILIA
Entity Type:Individual
Prefix:MRS
First Name:LAFONDRA
Middle Name:CECILIA
Last Name:JARING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 TOWER DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3555
Mailing Address - Country:US
Mailing Address - Phone:757-317-0600
Mailing Address - Fax:757-317-0900
Practice Address - Street 1:2708 NE 14TH ST
Practice Address - Street 2:SUITE 5, BUTTERFLY EFFECTS
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-3565
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist