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NPI 1306221791

NPI 1306221791 : EDEE CONRAD M.AC, L.AC. : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1306221791
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    Entity Type          |    Individual 
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    Provider Name        |    EDEE CONRAD M.AC, L.AC.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/27/2015
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    Last Update Date     |    04/06/2018
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Provider Practice Location Address
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    Address Line         |    2122 P ST NW STE 302 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20037-1037
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    Country              |    US
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    Telephone            |    202-257-3287
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3909 HIGHWOOD CT NW 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20007-2132
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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       |    U02258
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    500264
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    License Number State |    DC
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