Individual
KIMBERLY ZANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED COSMETOLOGY
Contact information
Practice address
11015 GOODWOOD BLVD, BATON ROUGE, LA 70815-5222
(225) 329-6699
Mailing address
11015 GOODWOOD BLVD, BATON ROUGE, LA 70815-5222
(225) 329-6699
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
298836
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331125826
TAX IDENTIFICATION NUMBER
LA
Enumeration date
07/13/2011
Last updated
07/13/2011
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