Provider Demographics
NPI:1245565597
Name:LAMOUREUX, KRISTY (AUD)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:LAMOUREUX
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-2240
Mailing Address - Country:US
Mailing Address - Phone:508-887-6283
Mailing Address - Fax:
Practice Address - Street 1:21 SHERWOOD LN
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-2240
Practice Address - Country:US
Practice Address - Phone:508-887-6283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA867231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist