Provider Demographics
NPI:1750457826
Name:BAPTISTE-PARENT, ALYSON THERESA (LADC)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:THERESA
Last Name:BAPTISTE-PARENT
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-5229
Mailing Address - Country:US
Mailing Address - Phone:860-643-7421
Mailing Address - Fax:
Practice Address - Street 1:117 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5203
Practice Address - Country:US
Practice Address - Phone:860-643-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000561101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)