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General NPI Number Information
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NPI Number | 1528343084
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Entity Type | Individual
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Provider Name | ISALENA MERRITT O'DONNELL M.AC. L.AC.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 1802 WEBSTER ST
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City | BALTIMORE
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State | MD
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Zip | 21230-4755
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Country | US
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Telephone | 443-691-2349
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Fax |
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Provider Business Mailing Address
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Address Line | 8821 COLUMBIA 100 PKWY SUITE 5
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City | COLUMBIA
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State | MD
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Zip | 21045-2274
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Country | US
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Telephone | 443-691-2349
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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 | U01940
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License Number State | MD
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