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General NPI Number Information
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NPI Number | 1417343658
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Entity Type | Individual
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Provider Name | TAMMY MARIA LALONDE L.AC.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 12820 107 AVE NW
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City | EDMONTON
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State | AB
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Zip | T5M 1Z9
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Country | CA
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Telephone | 780-633-7538
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Fax |
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Provider Business Mailing Address
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Address Line | 12820 107 AVE NW
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City | EDMONTON
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State | AB
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Zip | T5M 1Z9
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Country | CA
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Telephone | 780-633-7538
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 16419
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License Number State | CA
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