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General NPI Number Information
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NPI Number | 1942110176
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Entity Type | Organization
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Legal Business Name | DELISA HAIR STUDIO
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 3050 WASHTENAW AVE
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City | ANN ARBOR
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State | MI
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Zip | 48104-5160
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Country | US
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Telephone | 248-521-0655
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1177
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City | BRIGHTON
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State | MI
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Zip | 48116-2777
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Country | US
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Telephone | 248-521-0655
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Fax |
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Authorized Official
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Title or Position | COSMETOLOGIST
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Name | DELISA SHEPHERD
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Credential | CPSPECIALIST
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Telephone | 248-521-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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