Provider Demographics
NPI:1669046124
Name:THE HAIRDOCTA
Entity Type:Organization
Organization Name:THE HAIRDOCTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HOLISITC HAIR PRACTITIONE
Authorized Official - Prefix:
Authorized Official - First Name:ALYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-602-6743
Mailing Address - Street 1:8160 N THOMAS MEYERS DR APT G
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-9512
Mailing Address - Country:US
Mailing Address - Phone:816-602-6743
Mailing Address - Fax:
Practice Address - Street 1:190 NE 91ST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-3329
Practice Address - Country:US
Practice Address - Phone:816-602-6743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies