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General NPI Number Information
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NPI Number | 1174841282
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Entity Type | Individual
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Provider Name | MARIE WOOLLACOTT LIC.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 160 OLD DERBY ST STE 457
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City | HINGHAM
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State | MA
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Zip | 02043-4005
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Country | US
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Telephone | 781-741-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 670R MAIN ST
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City | HINGHAM
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State | MA
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Zip | 02043-3120
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Country | US
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Telephone | 508-439-9558
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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 | 238167
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License Number State | MA
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