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General NPI Number Information
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NPI Number | 1245926179
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Entity Type | Organization
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Legal Business Name | PINK DIAMOND BEAUTY MALL DETROIT LLC
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 17350 LIVERNOIS AVE
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City | DETROIT
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State | MI
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Zip | 48221-2759
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Country | US
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Telephone | 855-683-7465
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Fax |
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Provider Business Mailing Address
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Address Line | 17350 LIVERNOIS AVE
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City | DETROIT
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State | MI
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Zip | 48221-2759
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Country | US
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Telephone | 313-768-6983
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATRINA BELIN
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Credential |
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Telephone | 855-683-7465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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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 | 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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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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