Provider Demographics
NPI:1316539968
Name:TAYLOR-ONU LEBAKA MENDA, JENNIFER (DAC, LAC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TAYLOR-ONU LEBAKA MENDA
Suffix:
Gender:F
Credentials:DAC, LAC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:HUTCHISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22685 THREE NOTCH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-3152
Mailing Address - Country:US
Mailing Address - Phone:301-202-4053
Mailing Address - Fax:
Practice Address - Street 1:22685 THREE NOTCH RD STE 202
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-3152
Practice Address - Country:US
Practice Address - Phone:301-202-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist