Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1043466436 |
---|---|
Provider Name | Dr. Michael J Lafarr JR. |
First Address | Waltham, MA 02453-2728 |
Second Address | Waltham, MA 02453-2728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 03/01/2014 |