Provider Demographics
NPI:1659008597
Name:ESSENTIAL AESTHETICS AND LASER., LLC
Entity Type:Organization
Organization Name:ESSENTIAL AESTHETICS AND LASER., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER(LICENSED ESTHETICIAN)
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALESSANDRINI
Authorized Official - Suffix:
Authorized Official - Credentials:LE
Authorized Official - Phone:980-239-1313
Mailing Address - Street 1:8145 ARDREY KELL RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-625-6567
Mailing Address - Fax:
Practice Address - Street 1:8145 ARDREY KELL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-625-6567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESSENTIAL AESTHETICS AND LASER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Multi-Specialty
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty