Provider Demographics
NPI:1346873742
Name:CLAPP, CAROLYN ELAINE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ELAINE
Last Name:CLAPP
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 FREE TER
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5903
Mailing Address - Country:US
Mailing Address - Phone:240-601-5138
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE STE 300
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3614
Practice Address - Country:US
Practice Address - Phone:301-565-4924
Practice Address - Fax:301-565-4927
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM00173225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist