Basic Information
| Provider Information | |||||||||
| NPI: | 1346377454 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAFOUNTAIN | ||||||||
| FirstName: | LYNDA | ||||||||
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| Credential: | RNCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 BAYBERRY DR | ||||||||
| Address2: | |||||||||
| City: | EASTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010272735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135401100 | ||||||||
| FaxNumber: | 4135342544 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 BEECH STREET | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4138278959 | ||||||||
| FaxNumber: | 4138277015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2007 | ||||||||
| LastUpdateDate: | 03/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 181051 | MA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.