Individual
MRS. SISHANA JANELLE GERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
10502032
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1744P3200X
NON SURGICAL HAIR REPLACEMENT
—
Enumeration date
03/07/2014
Last updated
03/13/2014
Update your record
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