Provider Demographics
NPI:1578277299
Name:KARAOULIS, JOANNA (L AC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:KARAOULIS
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:OELLA
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4742
Mailing Address - Country:US
Mailing Address - Phone:267-918-6124
Mailing Address - Fax:
Practice Address - Street 1:8388 COURT AVE STE 104
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-5202
Practice Address - Country:US
Practice Address - Phone:267-918-6124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02946171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist