Provider Demographics
NPI:1922465863
Name:LALONDE, NAOMI (MMT)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:LALONDE
Suffix:
Gender:F
Credentials:MMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 S 2ND ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2809
Mailing Address - Country:US
Mailing Address - Phone:501-743-0497
Mailing Address - Fax:
Practice Address - Street 1:723 S 2ND ST UNIT C
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2809
Practice Address - Country:US
Practice Address - Phone:501-743-0497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7477225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist