Provider Demographics
NPI:1023173416
Name:ALAGAMMAI, ANDREA (LAC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:ALAGAMMAI
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 1:8900 E PALMS PARK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5643
Mailing Address - Country:US
Mailing Address - Phone:529-298-7222
Mailing Address - Fax:
Practice Address - Street 1:1601 N TUCSON BLVD
Practice Address - Street 2:STE 22
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3425
Practice Address - Country:US
Practice Address - Phone:520-298-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0163171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist