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General NPI Number Information
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NPI Number | 1992192454
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Entity Type | Individual
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Provider Name | SHANNON LEIGH KLEINMAN DACM, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 2008 EMELITA DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-1606
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Country | US
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Telephone | 760-216-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 EMELITA DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-1606
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Country | US
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Telephone | 760-216-8114
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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 | 0121001000
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License Number State | VA
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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 | 16447
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License Number State | CA
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