Provider Demographics
NPI:1538308812
Name:HARRISON WELLFORD, ELIZABETH W (L,AC, MAC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:W
Last Name:HARRISON WELLFORD
Suffix:
Gender:F
Credentials:L,AC, MAC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BAER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2242 49TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1057
Mailing Address - Country:US
Mailing Address - Phone:202-997-1312
Mailing Address - Fax:202-250-6667
Practice Address - Street 1:7009 CARROLL AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4429
Practice Address - Country:US
Practice Address - Phone:301-920-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01532171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist