Provider Demographics
NPI:1689082463
Name:LAFFOON, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LAFFOON
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 1:4120 LAKEFIELD DR
Mailing Address - Street 2:APT A
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-4173
Mailing Address - Country:US
Mailing Address - Phone:804-926-8078
Mailing Address - Fax:
Practice Address - Street 1:1610 FOREST AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5009
Practice Address - Country:US
Practice Address - Phone:804-282-5496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005880225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics