Individual
LEA TAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIC. AC.
Contact information
Practice address
200 LINCOLN ST, ROOM 301, BOSTON, MA 02111-2418
(617) 338-6818
Mailing address
11 JOHN ST, QUINCY, MA 02171-2507
(617) 338-6818
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
53
MA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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