Provider Demographics
NPI:1720307036
Name:TAKAHASHI, NANCY (M AC, L AC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:TAKAHASHI
Suffix:
Gender:F
Credentials:M AC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18249 PALADIN DR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3012
Mailing Address - Country:US
Mailing Address - Phone:240-888-3132
Mailing Address - Fax:
Practice Address - Street 1:237 ASHTON RD
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:MD
Practice Address - Zip Code:20861-3305
Practice Address - Country:US
Practice Address - Phone:240-888-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01361171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist