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General NPI Number Information
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NPI Number | 1033923347
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Entity Type | Organization
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Legal Business Name | THE SKINCRATIC METHOD, LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 767 CLUBHOUSE DR
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City | YPSILANTI
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State | MI
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Zip | 48197-4888
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Country | US
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Telephone | 407-982-4876
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Fax | 407-650-2754
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Provider Business Mailing Address
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Address Line | 767 CLUBHOUSE DR
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City | YPSILANTI
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State | MI
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Zip | 48197-4888
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Country | US
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Telephone | 734-787-8466
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIFER WILLIAMS
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Credential |
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Telephone | 407-982-4876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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