Provider Demographics
NPI:1861967945
Name:YALMIKIATHEHAIRDOCTOR
Entity type:Organization
Organization Name:YALMIKIATHEHAIRDOCTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAIR LOSS PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:YALMIKIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-274-7381
Mailing Address - Street 1:1205 CARLI CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3806
Mailing Address - Country:US
Mailing Address - Phone:443-274-7381
Mailing Address - Fax:
Practice Address - Street 1:7310 RITCHIE HWY STE 405
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3092
Practice Address - Country:US
Practice Address - Phone:443-274-7381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty