Mark La Fave

NPI #1588121172 in Brown Deer, Wisconsin

Provider Information

NPI Number: 1588121172
Entity Type: Individual
Name: Mark La Fave
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist
Enumeration Date: Mar 1, 2019
Last Updated: Mar 1, 2019

Practice Location

Address: 3900 W BROWN DEER RD STE 200
City: Brown Deer
State: Wisconsin
ZIP Code: 53209-1220
Phone: (414) 540-2170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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