Provider Demographics
NPI:1255653697
Name:HAIR THERAPY FOR WOMEN
Entity Type:Organization
Organization Name:HAIR THERAPY FOR WOMEN
Other - Org Name:RECOVER WITH CONFIDENCE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER HAIR SPEC
Authorized Official - Phone:813-269-4247
Mailing Address - Street 1:14027 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2401
Mailing Address - Country:US
Mailing Address - Phone:813-269-4247
Mailing Address - Fax:813-269-4248
Practice Address - Street 1:14027 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2401
Practice Address - Country:US
Practice Address - Phone:813-269-4247
Practice Address - Fax:813-269-4248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCE9963180332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies