Individual
IANA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
260 GATEWAY DR STE 11-12A, BEL AIR, MD 21014-4268
(410) 900-2227
Mailing address
251 W EARLY AVE, COALDALE, PA 18218-1129
(646) 239-0029
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U02749
MD
Other
Enumeration date
06/30/2020
Last updated
08/10/2020
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