Provider Demographics
NPI:1245259670
Name:LAVIGNE, SHARON A (MS, LGC)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:A
Last Name:LAVIGNE
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-6036
Mailing Address - Country:US
Mailing Address - Phone:860-679-3671
Mailing Address - Fax:860-523-6465
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-6036
Practice Address - Country:US
Practice Address - Phone:860-679-3671
Practice Address - Fax:860-679-0147
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
CT36170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS