Organization
DIVINE BEAUTY & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRAHNA JEFFERSON CERTIFIED HAIR LOSS (CEO/OWNER)
(410) 304-3127
Entity
Organization
Contact information
Practice address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(410) 304-3127
Mailing address
8125 SUBET RD, WINDSOR MILL, MD 21244-2973
(443) 744-0054
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
02/09/2018
Last updated
08/16/2023
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