Provider Demographics
NPI:1184488140
Name:LAPORTE, ALLYSON MARIE
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:MARIE
Last Name:LAPORTE
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 1:663 WHITNEY AVE
Mailing Address - Street 2:APT 13
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-837-7213
Mailing Address - Fax:
Practice Address - Street 1:55 WALLS DR STE 204
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5163
Practice Address - Country:US
Practice Address - Phone:203-255-3669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT18.007612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist