Provider Demographics
NPI:1679398044
Name:LAMONTAGNE, ALYSON ROSE (MASTER DEGREE)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:ROSE
Last Name:LAMONTAGNE
Suffix:
Gender:F
Credentials:MASTER DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 N LILLEY RD STE 115
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3695
Mailing Address - Country:US
Mailing Address - Phone:734-981-3709
Mailing Address - Fax:
Practice Address - Street 1:5900 N LILLEY RD STE 115
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3695
Practice Address - Country:US
Practice Address - Phone:734-981-3709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist