Provider Demographics
NPI:1528271053
Name:CROWLEY, ANNE CHRISTINE (LAC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CHRISTINE
Last Name:CROWLEY
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 1:7800 SUNNEHANNA CT
Mailing Address - Street 2:
Mailing Address - City:PORT TOBACCO
Mailing Address - State:MD
Mailing Address - Zip Code:20677-2029
Mailing Address - Country:US
Mailing Address - Phone:301-932-6125
Mailing Address - Fax:301-934-2128
Practice Address - Street 1:7800 SUNNEHANNA CT
Practice Address - Street 2:
Practice Address - City:PORT TOBACCO
Practice Address - State:MD
Practice Address - Zip Code:20677
Practice Address - Country:US
Practice Address - Phone:301-932-6125
Practice Address - Fax:301-934-2128
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01130171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBN63ACOtherBLUE CROSS NON-PAR #