Healthcare Provider Details

I. General information

NPI: 1215354097
Provider Name (Legal Business Name): SUZETTE ROBINSON HAIR LOSS SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ELLER DR
BIRMINGHAM AL
35215-3193
US

IV. Provider business mailing address

800 ELLER DR
BIRMINGHAM AL
35215-3193
US

V. Phone/Fax

Practice location:
  • Phone: 205-503-9916
  • Fax:
Mailing address:
  • Phone: 205-503-9916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: