Provider Demographics
NPI:1962268904
Name:LAROCCA, ALISON (LAC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:LAROCCA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BOTSFORD AVE APT A
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5863
Mailing Address - Country:US
Mailing Address - Phone:203-331-5052
Mailing Address - Fax:
Practice Address - Street 1:4 ARMSTRONG RD STE T120
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4721
Practice Address - Country:US
Practice Address - Phone:203-842-8631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT871171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist