Healthcare Provider Details

I. General information

NPI: 1831733823
Provider Name (Legal Business Name): ANOINTED HANDS TRICHOLOGY CENTER FOR HAIR LOSS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15153 HIGHWAY 44 STE B
GONZALES LA
70737-6897
US

IV. Provider business mailing address

15153 HIGHWAY 44 STE B
GONZALES LA
70737-6897
US

V. Phone/Fax

Practice location:
  • Phone: 225-622-4357
  • Fax: 225-622-4357
Mailing address:
  • Phone: 225-622-4357
  • Fax: 225-622-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. YNOHTNA M TUREAUD
Title or Position: OWNER
Credential: TRICHOLOGIST P, CMF
Phone: 225-622-4357