MEDICARE: SOOTHING SCALPS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1851066377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOOTHING SCALPS LLC

Provider Business Mailing Address
First Line	:	901 BRIARVISTA WAY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3627
Country	:	US
Telephone Number	:	404-392-1915
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 BRIARVISTA WAY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3627
Country	:	US
Telephone Number	:	404-392-1915
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASMINE LAMANS HARRIS
Credential	:
Telephone Number	:	404-392-1915

Provider Enumeration Date	:	08/16/2021
Last Update Date	:	08/16/2021

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