Provider Demographics
NPI:1952838807
Name:HOWARD, SHILOAH GERMAIN (LAC)
Entity Type:Individual
Prefix:
First Name:SHILOAH
Middle Name:GERMAIN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 HUMMINGBIRD CIR APT C
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-8862
Mailing Address - Country:US
Mailing Address - Phone:303-834-9494
Mailing Address - Fax:
Practice Address - Street 1:1225 KEN PRATT BLVD UNIT 222
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-9017
Practice Address - Country:US
Practice Address - Phone:720-202-1100
Practice Address - Fax:720-202-1100
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU0002275171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist