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General NPI Number Information
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NPI Number | 1861898983
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Entity Type | Individual
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Provider Name | JENNUM CHRISTINE O'HARA M.AC., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 5570 STERRETT PL SUITE 210
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City | COLUMBIA
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State | MD
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Zip | 21044-2641
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Country | US
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Telephone | 518-669-2982
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Fax |
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Provider Business Mailing Address
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Address Line | 16 S CHESTER ST APT 1
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City | BALTIMORE
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State | MD
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Zip | 21231-2007
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Country | US
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Telephone | 518-669-2982
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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 | U02156
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License Number State | MD
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