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General NPI Number Information
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NPI Number | 1639112253
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Entity Type | Individual
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Provider Name | ELAINE CARMELLA TRETTER LIC. AC., RN
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1134 YORK RD SUITE 208
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6215
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Country | US
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Telephone | 410-486-8380
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Fax |
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Provider Business Mailing Address
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Address Line | 6503 COPPER RIDGE DR. APT T1
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City | BALTIMORE
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State | MD
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Zip | 21209-2348
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Country | US
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Telephone | 410-486-6598
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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 | U01370
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | KO000539
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License Number State | PA
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