Provider Demographics
NPI:1396581070
Name:LAFONTAINE, SHELBY LANE HOPE
Entity type:Individual
Prefix:
First Name:SHELBY LANE
Middle Name:HOPE
Last Name:LAFONTAINE
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 1:413 W BRITTON RD APT 316
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-3550
Mailing Address - Country:US
Mailing Address - Phone:580-583-9862
Mailing Address - Fax:
Practice Address - Street 1:413 W BRITTON RD APT 316
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-3550
Practice Address - Country:US
Practice Address - Phone:580-583-9862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist