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General NPI Number Information
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NPI Number | 1497843783
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Entity Type | Individual
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Provider Name | TA YA LEE MSN NPC CRNP LAC
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 2360 W JOPPA RD STE 306
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City | LUTHERVILLE
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State | MD
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Zip | 21093
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Country | US
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Telephone | 410-847-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 9910 FRANKLIN SQUARE DR # 2110
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City | BALTIMORE
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State | MD
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Zip | 21236-4902
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Country | US
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Telephone | 410-933-5412
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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 | R123476
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R123476
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License Number State | MD
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