Provider Demographics
NPI:1346012549
Name:DELLAROCCO, KATHY
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:DELLAROCCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13005 OLD STAGE COACH RD APT 1513
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1632
Mailing Address - Country:US
Mailing Address - Phone:443-734-8700
Mailing Address - Fax:
Practice Address - Street 1:1202 ANNAPOLIS RD # SUIREE
Practice Address - Street 2:SUITE E
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1397
Practice Address - Country:US
Practice Address - Phone:410-417-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty