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Mrs. Laconda Gertrude Fanning, PSY,D,LPC
Professional Counselor in Hampton, Virginia
NPI 1700981396

Laconda Gertrude Fanning is a Professional Counselor based in Hampton, VA and is specialized in Professional. Laconda Gertrude Fanning practices in Hampton, VA and has the professional credentials of PSY,D,LPC. The NPI Number for Laconda Gertrude Fanning is 1700981396 and holds a License No. 0701003750 (Virginia).

The current practice location address for Laconda Gertrude Fanning is 600 Medical Dr, Hampton, VA and can be reached out via phone at 757-788-0600. You can also correspond with Laconda Gertrude Fanning through the mailing address at 300 MEDICAL DR, HAMPTON, VA - 23666-1765 (mailing address contact number: 757-788-0300).

Location: 600 Medical Dr, Hampton, VA, 23666-1765
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Provider Profile Details
NPI Number
1700981396
Provider Name
Laconda Gertrude Fanning
Credential
PSY,D,LPC
Provider Entity Type
Individual
Gender
Female
Address
600 Medical Dr, Hampton, VA, 23666-1765
Phone Number
757-788-0600
Fax Number
Provider Enumeration Date
09/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
010117241 05 VA
4945573 05 VA
institution
Provider Business Practice Location Address Details
Address
600 Medical Dr
City
State
Zip
23666-1769
Phone Number
757-788-0600
Fax Number
person
Provider Business Mailing Address Details
Address
600 Medical Dr
City
State
Zip
23666-1769
Phone Number
757-788-0600
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
0701003750 (Virginia)
Definition
Definition to come...
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