Provider Demographics
NPI:1669040499
Name:LAFOND, KATIA MARIE
Entity Type:Individual
Prefix:MS
First Name:KATIA
Middle Name:MARIE
Last Name:LAFOND
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 1:17 N PLANK RD STE 10
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2111
Mailing Address - Country:US
Mailing Address - Phone:845-800-9305
Mailing Address - Fax:844-800-1470
Practice Address - Street 1:15615 137TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-4309
Practice Address - Country:US
Practice Address - Phone:646-778-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty