Provider Demographics
NPI:1417343658
Name:LALONDE, TAMMY MARIA (LAC)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:MARIA
Last Name:LALONDE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12820 107 AVE NW
Mailing Address - Street 2:
Mailing Address - City:EDMONTON
Mailing Address - State:AB
Mailing Address - Zip Code:T5M 1Z9
Mailing Address - Country:CA
Mailing Address - Phone:780-633-7538
Mailing Address - Fax:
Practice Address - Street 1:12820 107 AVE NW
Practice Address - Street 2:
Practice Address - City:EDMONTON
Practice Address - State:AB
Practice Address - Zip Code:T5M 1Z9
Practice Address - Country:CA
Practice Address - Phone:780-633-7538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16419171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist