Provider Demographics
NPI:1326560632
Name:LAGUAITE, ELIZABETH DANNEMILLER (MMT, MT-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DANNEMILLER
Last Name:LAGUAITE
Suffix:
Gender:F
Credentials:MMT, MT-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:SAPER
Other - Last Name:DANNEMILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:621 DEXTER ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL FALLS
Mailing Address - State:RI
Mailing Address - Zip Code:02863-2742
Mailing Address - Country:US
Mailing Address - Phone:401-721-9200
Mailing Address - Fax:401-729-0010
Practice Address - Street 1:621 DEXTER ST
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-2742
Practice Address - Country:US
Practice Address - Phone:401-721-9200
Practice Address - Fax:401-729-0010
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11155225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist