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General NPI Number Information
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NPI Number | 1497035232
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Entity Type | Individual
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Provider Name | LAURIE BADOLATO M AC., L AC.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 1603 EDMONDSON AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-4960
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Country | US
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Telephone | 443-802-6240
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Fax |
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Provider Business Mailing Address
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Address Line | 4029 RALEIGH RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-5718
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Country | US
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Telephone | 410-486-7931
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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 | UO1926
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License Number State | MD
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