Provider Demographics
NPI:1598807976
Name:LAFOND, SHAUNA LEIGH (RD, LD, CNSC)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:LEIGH
Last Name:LAFOND
Suffix:
Gender:F
Credentials:RD, LD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 HOLT AVE
Mailing Address - Street 2:UNIT 1 SUITE 1400
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5603
Mailing Address - Country:US
Mailing Address - Phone:603-663-3130
Mailing Address - Fax:
Practice Address - Street 1:1070 HOLT AVE
Practice Address - Street 2:UNIT 1 SUITE 1400
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-5603
Practice Address - Country:US
Practice Address - Phone:603-663-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH960321133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered