Individual
EMILY LYNNE WYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BOND HAIR BAR
Contact information
Practice address
211 DE ANZA BLVD, SAN MATEO, CA 94402-3989
(650) 376-3582
Mailing address
211 DE ANZA BLVD, SAN MATEO, CA 94402-3989
(650) 771-3483
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
KK465558
CA
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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