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Individual

CYNTHIA GENRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COSMETOLOGIST

Contact information

Practice address
421 S MULFORD RD STE 203, ROCKFORD, IL 61108-3010
(815) 222-5187
Mailing address
7937 INGRAM RD, ROCKFORD, IL 61108-4710
(815) 222-5187

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
011.148061
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011.148061
COSMETOLOGIST
IL
Enumeration date
04/03/2019
Last updated
08/22/2024
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