Provider Demographics
NPI:1144473752
Name:LAFORNARA, REBECCA M (CAGS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:LAFORNARA
Suffix:
Gender:F
Credentials:CAGS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:M
Other - Last Name:MYSLINSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8999 SHANNON COURT
Mailing Address - Street 2:
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032
Mailing Address - Country:US
Mailing Address - Phone:716-432-4832
Mailing Address - Fax:
Practice Address - Street 1:8999 SHANNON COURT
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032
Practice Address - Country:US
Practice Address - Phone:716-432-4832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool