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General NPI Number Information
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NPI Number | 1326549478
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Entity Type | Organization
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Legal Business Name | SIMPLY BEAUTIFUL SKINCARE AND BODYWORK,LLC
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 14281 POTOMAC MILLS RD # 103
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City | WOODBRIDGE
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State | VA
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Zip | 22192-6805
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Country | US
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Telephone | 703-781-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 5623 SPRIGGS MEADOW DR
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City | WOODBRIDGE
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State | VA
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Zip | 22193-6217
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Country | US
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Telephone | 703-944-7388
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JERRI L CARR
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Credential |
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Telephone | 703-781-0188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | VA
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