Provider Demographics
NPI:1912208521
Name:TRANSFORMATIVE ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:TRANSFORMATIVE ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, LAC
Authorized Official - Phone:301-502-9140
Mailing Address - Street 1:5636 HOGENHILL TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2564
Mailing Address - Country:US
Mailing Address - Phone:301-502-9140
Mailing Address - Fax:
Practice Address - Street 1:30 W GUDE DR
Practice Address - Street 2:SUITE 375
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1161
Practice Address - Country:US
Practice Address - Phone:301-502-9140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01643171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty