Provider Demographics
NPI:1871771584
Name:COLABELLA ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:COLABELLA ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:COLABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:443-812-8451
Mailing Address - Street 1:7016 WALLIS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1711
Mailing Address - Country:US
Mailing Address - Phone:443-812-8451
Mailing Address - Fax:
Practice Address - Street 1:8 GREENSPRING VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4143
Practice Address - Country:US
Practice Address - Phone:410-654-8997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDUO1616171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty