Provider Demographics
NPI:1619783487
Name:LAFOND, SHIRLEY MENG
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:MENG
Last Name:LAFOND
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 1:1356 HERITAGE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1904
Mailing Address - Country:US
Mailing Address - Phone:571-376-8180
Mailing Address - Fax:
Practice Address - Street 1:1356 HERITAGE OAK WAY
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-1904
Practice Address - Country:US
Practice Address - Phone:571-376-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional