1851714182 NPI number — VANIETY CHERELLE REID HAIR PRACTITIONER

Table of content: VANIETY CHERELLE REID HAIR PRACTITIONER (NPI 1851714182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851714182 NPI number — VANIETY CHERELLE REID HAIR PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REID
Provider First Name:
VANIETY
Provider Middle Name:
CHERELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
HAIR PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851714182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6321 JAMES ROUSE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANAL WINCHESTER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43110-9676
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5160 EAST MAIN ST
Provider Second Line Business Practice Location Address:
LOFT 26
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-941-0493
Provider Business Practice Location Address Fax Number:
614-298-4025
Provider Enumeration Date:
01/22/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1744P3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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