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General NPI Number Information
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NPI Number | 1962397315
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Entity Type | Organization
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Legal Business Name | HAIR BOUTIQUE HUB, LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 4550 JOHN F KENNEDY BLVD STE D
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7364
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Country | US
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Telephone | 501-580-5644
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Fax |
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Provider Business Mailing Address
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Address Line | C/O 1601 NORTH SHACKLEFORD ROAD APT 312
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City | LITTLE ROCK
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State | AR
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Zip | 72211
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | NAKIYA HANEY
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Credential |
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Telephone | 501-508-0498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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