Provider Demographics
NPI:1952635500
Name:WENTZEL, NANDY ANNE (LAC, DIPLAC)
Entity Type:Individual
Prefix:
First Name:NANDY
Middle Name:ANNE
Last Name:WENTZEL
Suffix:
Gender:F
Credentials:LAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10717 LADY SLIPPER TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3403
Mailing Address - Country:US
Mailing Address - Phone:301-347-0146
Mailing Address - Fax:240-599-0762
Practice Address - Street 1:8218 WISCONSIN AVE
Practice Address - Street 2:STE 318
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3107
Practice Address - Country:US
Practice Address - Phone:301-347-0146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01385171100000X
VA0121000507171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist