Provider Demographics
NPI:1497292627
Name:LAFFERTY, ANNEMARIE LOUISE (CECP)
Entity type:Individual
Prefix:MS
First Name:ANNEMARIE
Middle Name:LOUISE
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:CECP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3753 HOWARD HUGHES PKWY STE 227
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-0938
Mailing Address - Country:US
Mailing Address - Phone:707-364-9019
Mailing Address - Fax:
Practice Address - Street 1:3753 HOWARD HUGHES PKWY STE 227
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-0938
Practice Address - Country:US
Practice Address - Phone:707-364-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician