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Individual

REBECCA DOUGLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.AC

Contact information

Practice address
10109 DAVIS AVE, GRANITE, MD 21163-1226
(410) 440-8875
Mailing address
14354 TRIADELPHIA MILL RD, DAYTON, MD 21036-1222

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U01319
MD

Other

Enumeration date
05/25/2012
Last updated
05/25/2012
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