Provider Demographics
NPI:1790536308
Name:ELECTROLOGY ESSENTIALS AND JACQUI OHHS SALON
Entity Type:Organization
Organization Name:ELECTROLOGY ESSENTIALS AND JACQUI OHHS SALON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED ELECTROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:CPE, RE
Authorized Official - Phone:414-303-0660
Mailing Address - Street 1:1507 E SUNSET DR STE 140
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-8213
Mailing Address - Country:US
Mailing Address - Phone:414-303-0660
Mailing Address - Fax:
Practice Address - Street 1:1507 E SUNSET DR STE 140
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-8213
Practice Address - Country:US
Practice Address - Phone:414-303-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty