Healthcare Provider Details

I. General information

NPI: 1114864006
Provider Name (Legal Business Name): CONFESSIONS OF A STYLIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 LIBERTY HEIGHTS AVE
BALTIMORE MD
21207-7055
US

IV. Provider business mailing address

5110 LIBERTY HEIGHTS AVE
BALTIMORE MD
21207-7055
US

V. Phone/Fax

Practice location:
  • Phone: 443-851-8386
  • Fax:
Mailing address:
  • Phone: 443-851-8386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS NORFLEET
Title or Position: SENIOR COSMETOLOGIST
Credential:
Phone: 443-851-8386