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General NPI Number Information
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NPI Number | 1114742533
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Entity Type | Organization
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Legal Business Name | DARE 2 KNOW HAIR RESTORATION CLINIC, LLC
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1916 SHILOH DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4031
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Country | US
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Telephone | 404-424-7537
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Fax |
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Provider Business Mailing Address
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Address Line | 1916 SHILOH DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4031
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Country | US
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Telephone | 404-424-7537
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MEKESHA DESHAY MELVIN
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Credential | HAIR LOSS SPECIALIS
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Telephone | 404-424-7537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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