Healthcare Provider Details

I. General information

NPI: 1164338703
Provider Name (Legal Business Name): MAKEUP BY DWOODZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 WOODLANE RD UNIT B4
EASTAMPTON NJ
08060-3902
US

IV. Provider business mailing address

1151 WOODLANE RD UNIT B4
EASTAMPTON NJ
08060-3902
US

V. Phone/Fax

Practice location:
  • Phone: 856-425-5328
  • Fax:
Mailing address:
  • Phone: 856-425-5328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: DESIRAE WOODS
Title or Position: OWNER
Credential:
Phone: 856-425-5328