Provider Demographics
NPI:1457526642
Name:CLARK-LARAMEE, NANCY JO (MA, CCC/A)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JO
Last Name:CLARK-LARAMEE
Suffix:
Gender:F
Credentials:MA, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 SHELBURNE RD
Mailing Address - Street 2:STE. D5
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7700
Mailing Address - Country:US
Mailing Address - Phone:802-862-1822
Mailing Address - Fax:
Practice Address - Street 1:1233 SHELBURNE RD
Practice Address - Street 2:STE. D5
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7700
Practice Address - Country:US
Practice Address - Phone:802-862-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist