Provider Demographics
NPI:1861240954
Name:FARLEY, TASHA (LAC)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:FARLEY
Suffix:
Gender:U
Credentials:LAC
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1401 PORTER ST APT 116
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5519
Mailing Address - Country:US
Mailing Address - Phone:720-837-5872
Mailing Address - Fax:
Practice Address - Street 1:10450 SHAKER DR STE 113
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2351
Practice Address - Country:US
Practice Address - Phone:410-730-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03102171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist