Provider Demographics
NPI:1053751206
Name:TRAN, DAISY Y (MAC, LAC)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:Y
Last Name:TRAN
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9033 SHADY GROVE CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1301
Mailing Address - Country:US
Mailing Address - Phone:301-869-9802
Mailing Address - Fax:301-869-2336
Practice Address - Street 1:9033 SHADY GROVE CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1301
Practice Address - Country:US
Practice Address - Phone:301-869-9802
Practice Address - Fax:301-869-2336
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02048171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU02048OtherACUPUNCTURE LICENSE