Provider Demographics
NPI:1891213211
Name:LAFRANCE, JACQUES N/A SR (MS)
Entity Type:Individual
Prefix:
First Name:JACQUES
Middle Name:N/A
Last Name:LAFRANCE
Suffix:SR
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:JACQUES
Other - Middle Name:N/A
Other - Last Name:LAFRANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:7171 CORAL WAY STE 404
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1693
Mailing Address - Country:US
Mailing Address - Phone:786-762-2474
Mailing Address - Fax:
Practice Address - Street 1:7171 CORAL WAY STE 404
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1693
Practice Address - Country:US
Practice Address - Phone:786-762-2474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT212106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty