BOBBY LASALLE (NPI# 1760910616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760910616 |
| Entity Type | Individual |
| Full Name | BOBBY LASALLE |
| Practice Address |
1327 Kalakaket St Fairbanks AK 99709-4917 |
| Practice Telephone | 9074524517 |
| Mailing Telephone | 9074524517 |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
44 | AK | Speech, Language and Hearing Service Providers |
| Street Address |
1327 KALAKAKET ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-4917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316914799 | Sandra L Jamison | Speech-Language Pathologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2006-03-03 |
| 1457816498 | Allana Jaclyn Lumbard | Occupational Therapist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2019-02-04 |
| 1790276335 | Scott Wiser | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2018-05-18 |
| 1295277655 | Alaina Ruble | Speech-Language Pathologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2016-11-15 |
| 1821440462 | Mckenna Wall-dunlap | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2016-07-07 |
| 1174991137 | Jaclyn Nicole Crook | Occupational Therapist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2015-09-08 |
| 1841675766 | Helen Graves | Speech-Language Pathologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2015-07-21 |
| 1952709727 | Jennifer Matz | Speech-Language Pathologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2014-12-10 |
| 1013358969 | Heather E Eisenman | Speech-Language Pathologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2013-07-08 |
| 1831538925 | Mary Marie Clancy | Speech-Language Pathologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2013-06-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790276335 | Scott Wiser | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2018-05-18 |
| 1821440462 | Mckenna Wall-dunlap | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2016-07-07 |
| 1386025260 | Marie Stover | Specialist/Technologist | 398 Hamilton Ave, Fairbanks, AK 99701-3537 | 2015-06-16 |
| 1265875942 | Rebecca Worthen | Specialist/Technologist | 398 Hamilton Ave, Fairbanks, AK 99701-3537 | 2013-04-11 |
| 1205127313 | Susan Celeste Updegraff | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2011-04-22 |
| 1548594138 | Magan Kathryn Wiggs | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2009-09-29 |
| 1962658617 | Adriel Helen Johnson | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2008-08-13 |
| 1700043056 | Brenda G Mccarley | Specialist/Technologist | 1327 Kalakaket St, Fairbanks, AK 99709-4917 | 2008-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245894310 | Mary Kathleen Tate | Specialist/Technologist | 205 E. Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-24 |
| 1144609967 | Andrea Lynne Swanson | Specialist/Technologist | 1630 W Riffle St, Wasilla, AK 99654-0910 | 2015-05-26 |
| 1770841090 | Janet Dougherty | Specialist/Technologist | 15815 Noble Point Dr, Anchorage, AK 99516-7552 | 2012-04-24 |
| 1114208881 | Faith Ridgway | Specialist/Technologist | 2150 E Dowling Rd, Suite C, Anchorage, AK 99507-1980 | 2011-09-07 |
| 1477844967 | Matthew Abelino Sandoval | Specialist/Technologist | 6340 Newt Dr, Anchorage, AK 99507-2047 | 2011-05-02 |
| 1154502565 | Lea Dawn Everson | Specialist/Technologist | 982 Lakloey Dr, North Pole, AK 99705-5356 | 2007-11-14 |
| 1134759723 | Amy Hagen | Specialist/Technologist | 35105 Kenai Spur Hwy Ste A, Soldotna, AK 99669-7658 | 2020-01-22 |
| 1245886720 | Erin Michelle John | Specialist/Technologist | 1901 N Hemmer Rd Ste 109, Palmer, AK 99645-9690 | 2019-08-12 |
| 1437618667 | Jennifer Marie Carlson | Specialist/Technologist | 613 S Knik Goose Bay Rd Ste B, Wasilla, AK 99654-8090 | 2019-03-18 |
| 1154891539 | T'essa Lanae Blossom | Specialist/Technologist | 35105 Kenai Spur Hwy Ste A, Soldotna, AK 99669-7658 | 2018-11-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.