Provider Demographics
NPI:1548575392
Name:LAROCHELLE FAUCHER, EVE (IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:
Last Name:LAROCHELLE FAUCHER
Suffix:
Gender:F
Credentials:IBCLC, RLC
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:
Other - Last Name:LAROCHELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:51 DUFTON RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2730
Mailing Address - Country:US
Mailing Address - Phone:978-842-4108
Mailing Address - Fax:
Practice Address - Street 1:51 DUFTON RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-2730
Practice Address - Country:US
Practice Address - Phone:978-842-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10959886174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist