Provider Demographics
NPI:1528290293
Name:WATKINS, KARI (MAC, LAC, DIPLA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MAC, LAC, DIPLA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5710 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3657
Mailing Address - Country:US
Mailing Address - Phone:410-916-5579
Mailing Address - Fax:
Practice Address - Street 1:5710 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3657
Practice Address - Country:US
Practice Address - Phone:410-916-5579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01437171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist