Organization
EXXCLUSIVE H20 INC
Active
Other names
Exxcluisve Hair Inc Hair Replacement
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATIQUA D WILLIAMS CERTIFIED HAIR LOSS (CEO/ FOUNDER)
(646) 325-4841
Entity
Organization
Contact information
Practice address
6 E CLARKE PL, BRONX, NY 10452-7501
(646) 325-4841
(646) 410-0244
Mailing address
2130 1ST AVE APT 212, NEW YORK, NY 10029-3322
(646) 325-4841
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1744P3200X
CERTIFIED HAIR LOSS SPECIALIST
NY
Enumeration date
03/08/2016
Last updated
03/09/2016
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