Provider Demographics
NPI:1285870378
Name:HUGGAR, MARY LOUISE (COSMETOLOGY LICENSE)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:HUGGAR
Suffix:
Gender:F
Credentials:COSMETOLOGY LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 44TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412-1162
Mailing Address - Country:US
Mailing Address - Phone:612-521-5275
Mailing Address - Fax:612-353-6706
Practice Address - Street 1:2139 44TH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55412-1162
Practice Address - Country:US
Practice Address - Phone:612-521-5275
Practice Address - Fax:612-353-6706
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X
MNCS20512052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No173C00000XOther Service ProvidersReflexologist