Individual
TYRONELL MONIQUE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLOGIST
Contact information
Practice address
4066 GIBSON ST, NEW ORLEANS, LA 70122-1622
(504) 266-6601
Mailing address
4066 GIBSON ST, NEW ORLEANS, LA 70122-1622
(504) 266-6601
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
386069
LA
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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