Provider Demographics
NPI:1336309079
Name:PEPPER, ANNE L (LIC AC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:PEPPER
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 1:76 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8726
Mailing Address - Country:US
Mailing Address - Phone:781-646-3141
Mailing Address - Fax:
Practice Address - Street 1:76 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8726
Practice Address - Country:US
Practice Address - Phone:781-646-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA83171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist