Individual
DORA HAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 WESTHAVEN BLVD, JACKSON, MS 39209-5728
(601) 922-8466
(601) 488-0421
Mailing address
1625 WESTHAVEN BLVD, JACKSON, MS 39209-5728
(601) 922-8466
(601) 488-0421
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
00422545
MS
376J00000X
Homemaker
01473740
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00422545
—
MS
05
—
01473740
—
MS
Enumeration date
03/09/2008
Last updated
03/09/2008
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