Provider Demographics
NPI:1639503733
Name:LAVIGNE, HARMON LANDON
Entity Type:Individual
Prefix:
First Name:HARMON
Middle Name:LANDON
Last Name:LAVIGNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 JOHNSTON ST STE 502
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5334
Mailing Address - Country:US
Mailing Address - Phone:337-704-2228
Mailing Address - Fax:337-704-2240
Practice Address - Street 1:6755 PHELAN BLVD STE 22
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6076
Practice Address - Country:US
Practice Address - Phone:409-839-4900
Practice Address - Fax:409-839-4901
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1232237700000X
TX80592237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist