=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992389449
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIYING ACUPUNCTURE HEALING SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2021
-----------------------------------------------------
Last Update Date | 05/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8975 GUILFORD RD STE 170
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21046-2389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-453-7727
-----------------------------------------------------
Fax | 410-247-4635
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 INGATE TER
-----------------------------------------------------
City | HALETHORPE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21227-3849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-453-7727
-----------------------------------------------------
Fax | 410-247-4635
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAG
-----------------------------------------------------
Name | KATHY DIAO
-----------------------------------------------------
Credential | L.AC.
-----------------------------------------------------
Telephone | 443-453-7727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------