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General NPI Number Information
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NPI Number | 1912603200
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Entity Type | Organization
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Legal Business Name | NATURAL HAIR HAVEN SALON
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 1801 N UNIVERSITY DR STE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8920
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Country | US
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Telephone | 954-532-0279
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Fax |
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Provider Business Mailing Address
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Address Line | 11526 LAKEVIEW DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-7867
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Country | US
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Telephone | 954-614-9032
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORIANE NADINE WRAY
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Credential | TRICHOLOGIST
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Telephone | 954-614-9032
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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 | 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 #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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