Provider Demographics
NPI:1700372315
Name:LABARRE, STACEY ELIZABETH
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:ELIZABETH
Last Name:LABARRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:612-351-1529
Mailing Address - Fax:952-285-3980
Practice Address - Street 1:27 HARTFORD TPKE STE 83
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-5245
Practice Address - Country:US
Practice Address - Phone:860-646-7900
Practice Address - Fax:860-646-7792
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT447237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist