Individual
MS. EBONI SHAVON EVERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIRLOSS S
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
001141
OH
1744P3200X
Prosthetics Case Management
001141
OH
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
001141
OH
335E00000X
Prosthetic/Orthotic Supplier
001141
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001141
CRRTIFIED HAIR LOSS SPECIALIST
OH
Enumeration date
12/11/2018
Last updated
07/12/2023
Update your record
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