Benedetta S Hair Salon & Spa Co Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

2701290519 Issued in MI

Legal business name

BENEDETTA S HAIR SALON & SPA CO INC.

Practice address

42302 Hayes Rd
Clinton Township, MI 48038-3620

Phone

(586) 263-9968

Fax

(586) 263-3947

NPI assigned

Jul 23, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Elizabeth Sandra Gagnon, COMETOLOGIST

Title

Medical Hair Loss

Phone

(586) 263-9968

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1124373428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42302 HAYES RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383620",
            "telephone_number": "586-263-9968",
            "fax_number": "586-263-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42302 HAYES RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383620",
            "telephone_number": "586-263-9968",
            "fax_number": "586-263-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEDETTA S HAIR SALON & SPA CO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "SANDRA",
        "authorized_official_title_or_position": "MEDICAL HAIR LOSS",
        "authorized_official_telephone_number": "586-263-9968",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COMETOLOGIST"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "2701290519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.