Provider Demographics
NPI:1053198838
Name:LACHANCE, PATTI ANN
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:ANN
Last Name:LACHANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SUMMER WHEAT DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-8647
Mailing Address - Country:US
Mailing Address - Phone:707-836-0290
Mailing Address - Fax:
Practice Address - Street 1:79 CRYSTAL PARK RD APT A
Practice Address - Street 2:
Practice Address - City:MANITOU SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80829-2567
Practice Address - Country:US
Practice Address - Phone:707-888-8006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist