Provider Demographics
NPI:1124349105
Name:JENNINGS-ROJAS, SHARON ANDREA (LAC)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANDREA
Last Name:JENNINGS-ROJAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9199 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 203 - B
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4520
Mailing Address - Country:US
Mailing Address - Phone:410-340-0189
Mailing Address - Fax:410-581-9174
Practice Address - Street 1:10440 SHAKER DR
Practice Address - Street 2:SUITE 103
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1200
Practice Address - Country:US
Practice Address - Phone:410-340-0189
Practice Address - Fax:888-953-0005
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD-U1056171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist