Provider Demographics
NPI:1336216076
Name:ROHAN, JANE M (LIC AC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:ROHAN
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 1:502 CLUB LN
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-7302
Mailing Address - Country:US
Mailing Address - Phone:410-296-9314
Mailing Address - Fax:
Practice Address - Street 1:502 CLUB LN
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-7302
Practice Address - Country:US
Practice Address - Phone:410-296-9314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist