Healthcare Provider Details

I. General information

NPI: 1851760219
Provider Name (Legal Business Name): LAUDIE JEAN-FRANCOIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 03/30/2021
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S BI STATE BLVD UNIT A
DELMAR MD
21875-1648
US

IV. Provider business mailing address

18229 DUPONT BLVD
GEORGETOWN DE
19947-3127
US

V. Phone/Fax

Practice location:
  • Phone: 410-845-6268
  • Fax:
Mailing address:
  • Phone: 302-519-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-0004038
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: