Provider Demographics
NPI:1942491048
Name:CONDON, RACHEL S (LIC AC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:S
Last Name:CONDON
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 ELM ST # A
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2815
Mailing Address - Country:US
Mailing Address - Phone:413-586-8251
Mailing Address - Fax:
Practice Address - Street 1:160 MAIN ST, SUITE 23
Practice Address - Street 2:ACUPUCTURE AND ASIAN HEALING ARTS
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-586-8251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228817171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist