Healthcare Provider Details

I. General information

NPI: 1932160801
Provider Name (Legal Business Name): SHARAREH DAGHIGHI L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2182 TECUMSEH PARK LN
WEST LAFAYETTE IN
47906-2183
US

IV. Provider business mailing address

2182 TECUMSEH PARK LN
WEST LAFAYETTE IN
47906-2183
US

V. Phone/Fax

Practice location:
  • Phone: 765-715-0032
  • Fax:
Mailing address:
  • Phone: 765-715-0032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number84000255A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: