Provider Demographics
NPI:1407130859
Name:SULLIVAN-HOUNDALAS, HANORAH (LAC, DIPL AC)
Entity Type:Individual
Prefix:
First Name:HANORAH
Middle Name:
Last Name:SULLIVAN-HOUNDALAS
Suffix:
Gender:F
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 S ARDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-3813
Mailing Address - Country:US
Mailing Address - Phone:323-938-0046
Mailing Address - Fax:323-938-8086
Practice Address - Street 1:632 S ARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-3813
Practice Address - Country:US
Practice Address - Phone:323-938-0046
Practice Address - Fax:323-938-8086
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7384171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist