Provider Demographics
NPI:1730317538
Name:LA PLANTE, BECKY MARIE (LAC)
Entity Type:Individual
Prefix:MISS
First Name:BECKY
Middle Name:MARIE
Last Name:LA PLANTE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LOVELY ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2975
Mailing Address - Country:US
Mailing Address - Phone:310-508-6641
Mailing Address - Fax:
Practice Address - Street 1:163 ALBANY TPKE STE 300
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2544
Practice Address - Country:US
Practice Address - Phone:860-709-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000576171100000X
CA12069171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist