Provider Demographics
NPI:1538812268
Name:MCALLISTER, MAUREEN LAURA (BS, E-RYT 500, YACEP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:LAURA
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:BS, E-RYT 500, YACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 TURKEY FOOT CT
Mailing Address - Street 2:
Mailing Address - City:DARNESTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3645
Mailing Address - Country:US
Mailing Address - Phone:301-802-4993
Mailing Address - Fax:
Practice Address - Street 1:23330 FREDERICK RD FL 3
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-9704
Practice Address - Country:US
Practice Address - Phone:301-802-4993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD281894171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach