Healthcare Provider Details

I. General information

NPI: 1982934733
Provider Name (Legal Business Name): WENDY J TAYLOR L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2009
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 19TH ST NW SUITE 250
WASHINGTON DC
20006-2105
US

IV. Provider business mailing address

1840 MINTWOOD PL NW #104
WASHINGTON DC
20009-1939
US

V. Phone/Fax

Practice location:
  • Phone: 202-997-0925
  • Fax:
Mailing address:
  • Phone: 202-997-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC500112
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: