Provider Demographics
NPI:1689878027
Name:OLEARY, SARAH E (LAC, MAC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:OLEARY
Suffix:
Gender:F
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 ROLAND AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2437
Mailing Address - Country:US
Mailing Address - Phone:410-235-1776
Mailing Address - Fax:
Practice Address - Street 1:3600 ROLAND AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2437
Practice Address - Country:US
Practice Address - Phone:410-235-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01536171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist