Organization
AYABA MED SPA, LLC
Active
Organization
AYABA MED SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY REYNOLDS APRN, WHNP (CEO)
(888) 864-8928
Entity
Organization
Contact information
Practice address
351 W RANDOL MILL RD # 151, ARLINGTON, TX 76011-5733
(844) 864-8928
Mailing address
539 W COMMERCE ST # 4488, DALLAS, TX 75208-1953
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
05/18/2023
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