Healthcare Provider Details

I. General information

NPI: 1255161964
Provider Name (Legal Business Name): BEAUTI4YOU SALON & SPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MAIN ST
WORCESTER MA
01608-1723
US

IV. Provider business mailing address

47 EVERARD ST APT 2
WORCESTER MA
01605-3971
US

V. Phone/Fax

Practice location:
  • Phone: 843-999-6535
  • Fax:
Mailing address:
  • Phone: 843-999-6535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: PROF. RACHEL MARIE BELLAMY
Title or Position: HAIR REPLACEMENT SPECIALIST
Credential: LICENSE
Phone: 843-999-6535