Provider Demographics
NPI:1649527789
Name:BAIHLY, NATASHA (LAC)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:BAIHLY
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 1:27 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-1236
Mailing Address - Country:US
Mailing Address - Phone:301-432-4940
Mailing Address - Fax:301-432-1120
Practice Address - Street 1:27 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1236
Practice Address - Country:US
Practice Address - Phone:301-432-4940
Practice Address - Fax:301-432-1120
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01673171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist