Provider Demographics
NPI:1508547142
Name:LANFORD-HARRIS, ASIA (LAC)
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:LANFORD-HARRIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 AUER CT STE G
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5826
Mailing Address - Country:US
Mailing Address - Phone:732-672-8754
Mailing Address - Fax:732-399-6451
Practice Address - Street 1:4 AUER CT STE G
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5826
Practice Address - Country:US
Practice Address - Phone:732-672-8754
Practice Address - Fax:732-399-6451
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00734600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health