Provider Demographics
NPI:1689961849
Name:KATSUMI, MARI (MAC, LAC)
Entity Type:Individual
Prefix:MS
First Name:MARI
Middle Name:
Last Name:KATSUMI
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 1:4127 WOODBINE ST.
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815
Mailing Address - Country:US
Mailing Address - Phone:301-652-7109
Mailing Address - Fax:
Practice Address - Street 1:8505 FENTON ST.
Practice Address - Street 2:SUITE 202
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-565-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01743171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist