Provider Demographics
NPI:1588436851
Name:THE HAIR THERAPY LOUNGE LLC
Entity type:Organization
Organization Name:THE HAIR THERAPY LOUNGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LASHAUN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED HAIR LOSS
Authorized Official - Phone:202-975-1096
Mailing Address - Street 1:2407 24TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3406
Mailing Address - Country:US
Mailing Address - Phone:202-489-4691
Mailing Address - Fax:
Practice Address - Street 1:605 CHESAPEAKE ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3635
Practice Address - Country:US
Practice Address - Phone:202-975-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty