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General NPI Number Information
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NPI Number | 1114721719
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Entity Type | Organization
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Legal Business Name | ALLURING AESTHETICS PLLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 300 ELLICOTT ST STE D
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City | OCCOQUAN
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State | VA
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Zip | 22125-7715
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Country | US
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Telephone | 904-540-1391
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Fax |
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Provider Business Mailing Address
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Address Line | 12760 QUARTERHORSE LN
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5046
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Country | US
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Telephone | 904-540-1391
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFFER LYNN REIS
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Credential | ARNP
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Telephone | 904-540-1391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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