Provider Demographics
NPI:1528234820
Name:GIROLAMI, THERESA MARIE (LAC)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:GIROLAMI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CMT
Mailing Address - Street 1:497 RITCHIE HWY STE 2C
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2935
Mailing Address - Country:US
Mailing Address - Phone:410-544-5155
Mailing Address - Fax:
Practice Address - Street 1:497 RITCHIE HWY STE 2C
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2935
Practice Address - Country:US
Practice Address - Phone:410-544-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00473171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BE43THOtherBCBS