Provider Demographics
NPI:1295515674
Name:GAGNON, ALLISON LYNN (LMT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LYNN
Last Name:GAGNON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LYNN
Other - Last Name:PAQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03263-3214
Mailing Address - Country:US
Mailing Address - Phone:603-793-0914
Mailing Address - Fax:
Practice Address - Street 1:635 MAIN ST STE I
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3415
Practice Address - Country:US
Practice Address - Phone:603-965-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7193M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist