Provider Demographics
NPI:1629437231
Name:HERMAN, KATHERINE (MAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 SHEFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1626
Mailing Address - Country:US
Mailing Address - Phone:443-698-8776
Mailing Address - Fax:
Practice Address - Street 1:364 SHEFFIELD RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-1626
Practice Address - Country:US
Practice Address - Phone:443-562-9931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02274171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist