Provider Demographics
NPI:1992424410
Name:LAFOREST, ANGE SHEILA
Entity type:Individual
Prefix:MISS
First Name:ANGE
Middle Name:SHEILA
Last Name:LAFOREST
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 1:45 GARDEN RD APT D
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3039
Mailing Address - Country:US
Mailing Address - Phone:917-326-0196
Mailing Address - Fax:
Practice Address - Street 1:45 GARDEN RD APT D
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3039
Practice Address - Country:US
Practice Address - Phone:917-326-0196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician