Provider Demographics
NPI:1396085965
Name:WEHNER, SARAH (LAC DIPL)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WEHNER
Suffix:
Gender:F
Credentials:LAC DIPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 SHADYWOOD RD
Mailing Address - Street 2:#301
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6038
Mailing Address - Country:US
Mailing Address - Phone:540-645-7956
Mailing Address - Fax:
Practice Address - Street 1:153 MAYO RD
Practice Address - Street 2:SUITE 5
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1852
Practice Address - Country:US
Practice Address - Phone:540-645-7956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01597171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist