Provider Demographics
NPI:1639489099
Name:CREANEY, ABBE MCAULIFFE (MAC LAC)
Entity Type:Individual
Prefix:MRS
First Name:ABBE
Middle Name:MCAULIFFE
Last Name:CREANEY
Suffix:
Gender:F
Credentials:MAC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:MD
Mailing Address - Zip Code:21013-9360
Mailing Address - Country:US
Mailing Address - Phone:410-925-5272
Mailing Address - Fax:
Practice Address - Street 1:5312 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:MD
Practice Address - Zip Code:21013-9360
Practice Address - Country:US
Practice Address - Phone:410-925-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01722171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist