Individual
LARISSA RENEE BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 POND RD STE 203, ALLENTOWN, PA 18104-2254
(610) 366-1366
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
(484) 884-4500
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
2109
TN
231H00000X
Audiologist
Primary
AT007075
PA
Other
Enumeration date
07/03/2023
Last updated
12/03/2025
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