# TSP AT HAVEN ON THE LAKE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255793485
- **Authorized official:** MS. TORI LYNN PAIDE L.AC (OWNER)
- **Authorized official phone:** (202) 352-5289

## Contact information

- **Practice address:** 10275 LITTLE PATUXENT PKWY, SUITE 102, COLUMBIA, MD 21044-3412
- **Practice address phone:** (202) 352-5289
- **Mailing address:** 5570 STERRETT PL, \#202, COLUMBIA, MD 21044-2641
- **Mailing address phone:** (202) 352-5289

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | U01486 | MD | Yes |

## Other

- **Enumeration date:** 03/26/2016
- **Last updated:** 03/26/2016