Provider Demographics
NPI:1861508681
Name:LABONTE, CONSTANCE ROSE
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:ROSE
Last Name:LABONTE
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 1:239 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-2035
Mailing Address - Country:US
Mailing Address - Phone:781-289-9435
Mailing Address - Fax:
Practice Address - Street 1:239 CONANT ST
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-2035
Practice Address - Country:US
Practice Address - Phone:781-289-9435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor