Jessica Marie Lafontaine
Social Worker, Clinical in West Melbourne, FL. Individual provider (NPI-1).
NPI number1962035907
StatusActive
Last updated in NPPESMar 22, 2021
Details
- NPI
- 1962035907
- Entity type
- Individual (NPI-1)
- Name
- Jessica Marie Lafontaine
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 18, 2020
- Certification date
- Mar 22, 2021
- Last updated
- Mar 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Other names
- Jessica Mikulas (Former Name)
Practice location
630 S Wickham Rd Ste 107West Melbourne, FL 32904-1429
Phone 321-608-0604
Mailing address
630 S Wickham Rd Ste 107West Melbourne, FL 32904-1429
Phone 321-608-0604
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