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General NPI Number Information
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NPI Number | 1326458316
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Entity Type | Individual
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Provider Name | MARY G. MARESCA-JAY LICENSED ACUPUNCTURI
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 2109 SANFORD PL
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City | KNOXVILLE
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State | TN
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Zip | 37917-4445
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Country | US
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Telephone | 203-848-0876
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 SANFORD PL
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City | KNOXVILLE
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State | TN
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Zip | 37917-4445
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Country | US
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Telephone | 203-848-0876
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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 | 522
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License Number State | TN
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