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General NPI Number Information
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NPI Number | 1396252714
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Entity Type | Individual
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Provider Name | OLGA MARIA MARDACH-DUCLERC M.SC. L.AC, DIPL. OM
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Gender | Female
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 15 OLD ROLLINSFORD RD STE 204
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City | DOVER
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State | NH
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Zip | 03820-2869
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Country | US
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Telephone | 603-740-2130
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Fax | 603-740-9528
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Provider Business Mailing Address
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Address Line | PO BOX 412503
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City | BOSTON
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State | MA
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Zip | 02241-2503
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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 | 365
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License Number State | NH
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