Individual
MS. TARYN PERSIA LACASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 742-8787
(603) 740-2446
Mailing address
PO BOX 412503, BOSTON, MA 02241-2503
(617) 726-3884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1875
NH
363AM0700X
Medical Physician Assistant
1875
NH
363AM0700X
Medical Physician Assistant
PA4224
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110121445A
—
MA
Enumeration date
09/01/2011
Last updated
08/22/2024
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