Doctor Name: | LAMONT MCPHERON |
NPI Number: | 1487070439 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2084-226 |
Business Practice Address: | S1597 Hanson Rd Westby, WI - 546678396 |
Business Phone Number: | 6085740582 |
Business Fax Number: | 6086346918 |
Mailing Address: | 415 E Terhune St, VIROQUA |
State: | WI |
Postal Code: | 54665 |
Phone Number: | 6086063375 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2014 |
NPI Last Update Date: | 03/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2084-226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |