Provider Demographics
NPI:1548007990
Name:DOLLHOUSE BEAUTY SALON & BOUTIQUE
Entity type:Organization
Organization Name:DOLLHOUSE BEAUTY SALON & BOUTIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-564-7672
Mailing Address - Street 1:6331 WESTPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2415
Mailing Address - Country:US
Mailing Address - Phone:318-655-1154
Mailing Address - Fax:
Practice Address - Street 1:3018 LONG PINES DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71119-3413
Practice Address - Country:US
Practice Address - Phone:318-564-7672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA224P00000XOtherDURABLE MEDICAL EQUIPMENT