Provider Demographics
NPI:1811543796
Name:HAIR, SHENNA (CHES)
Entity Type:Individual
Prefix:
First Name:SHENNA
Middle Name:
Last Name:HAIR
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 MELVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2552
Mailing Address - Country:US
Mailing Address - Phone:410-900-5162
Mailing Address - Fax:
Practice Address - Street 1:607 MELVILLE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2552
Practice Address - Country:US
Practice Address - Phone:410-900-5162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator