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NPI 1093379224

NPI 1093379224 : ALEXANDRA STRAWBRIDGE MAURER LAC : PORTLAND, ME

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General NPI Number Information
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    NPI Number           |    1093379224
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDRA STRAWBRIDGE MAURER LAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/23/2019
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    Last Update Date     |    04/23/2019
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Provider Practice Location Address
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    Address Line         |    50 A COVE STREET 
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    City                 |    PORTLAND
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    State                |    ME
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    Zip                  |    04101
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    Country              |    US
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    Telephone            |    207-749-1417
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    464 BLACK POINT RD 
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    City                 |    SCARBOROUGH
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    State                |    ME
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    Zip                  |    04074
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    AC216
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    License Number State |    ME
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