Provider Demographics
NPI:1235913401
Name:LEVONYE PROFESSIONALS LLC
Entity Type:Organization
Organization Name:LEVONYE PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAIR LOSS PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:YALMIKIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:HAIR LOSS PRACTIONER
Authorized Official - Phone:800-536-0516
Mailing Address - Street 1:7504 BRIARGROVE LN
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8389
Mailing Address - Country:US
Mailing Address - Phone:800-536-0516
Mailing Address - Fax:
Practice Address - Street 1:420 CRAIN HWY S STE 2
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3657
Practice Address - Country:US
Practice Address - Phone:800-536-0516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty