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Organization

IRIE SALON AND SPA

Active
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Organization

IRIE SALON AND SPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS SANDRA SENIOR LMT (LEAD THERAPIST, MANAGER)
(917) 496-4691
Entity
Organization

Contact information

Practice address
895 PALISADE AVE, FORT LEE, NJ 07024-4122
(347) 901-6147
Mailing address
895 PALISADE AVE, FORT LEE, NJ 07024-4122
(347) 901-6147

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
302R00000X
Health Maintenance Organization
Primary
—
NULL

Other

Enumeration date
06/10/2019
Last updated
06/10/2019
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