Provider Demographics
NPI:1205588902
Name:YEN, JENNIFER BAILING (LICENSE ACUPUNCTURE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BAILING
Last Name:YEN
Suffix:
Gender:F
Credentials:LICENSE ACUPUNCTURE
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:BAILING
Other - Last Name:YEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:BLESSINGACUPUNCTURE@GMAIL.COM
Mailing Address - Street 2:14043 MARKETCENTER DR.
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871
Mailing Address - Country:US
Mailing Address - Phone:301-500-9367
Mailing Address - Fax:
Practice Address - Street 1:14043 MARKETCENTER DR
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-6343
Practice Address - Country:US
Practice Address - Phone:301-500-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02874171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU02874OtherACUPUNCTURE LICENSE