Healthcare Provider Details

I. General information

NPI: 1245521996
Provider Name (Legal Business Name): KRISTIN HUZA M.AC.,L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 TWIN KNOLLS RD STE 9
COLUMBIA MD
21045
US

IV. Provider business mailing address

6159 AGAIL PL
COLUMBIA MD
21045-4307
US

V. Phone/Fax

Practice location:
  • Phone: 410-336-0092
  • Fax:
Mailing address:
  • Phone: 410-336-0092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU01580
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: