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General NPI Number Information
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NPI Number | 1437780566
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL SECRETS LLC
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 224 BALA AVE
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2920
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Country | US
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Telephone | 484-270-8451
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Fax | 610-284-0304
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Provider Business Mailing Address
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Address Line | 300 E LANCASTER AVE APT 1101
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2112
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Country | US
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Telephone | 215-688-7255
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Fax | 610-284-0304
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Authorized Official
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Title or Position | OWNER/AESTHETICIAN
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Name | MS. DAWN MCCALL
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Credential |
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Telephone | 215-688-7255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH1100X
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Taxonomy Name | Holistic Clinical Nurse Specialist
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License Number |
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License Number State |
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