| Doctor Name: | MRS. DORETTA EASLEY RUE |
| NPI Number: | 1023271525 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | COSMETOLOGIST |
| License Number: | COSM774250 |
| Business Practice Address: | 345 Grandville Street Suite D Eneffect Hair Design Inc Gahanna, OH - 432303350 |
| Business Phone Number: | 6144715471 |
| Business Fax Number: | |
| Mailing Address: | 345 Grandville Street Suite D, Eneffect Hair Design Inc GAHANNA |
| State: | OH |
| Postal Code: | 432303350 |
| Phone Number: | 6144715471 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2008 |
| NPI Last Update Date: | 07/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744P3200X |
| License Number: | COSM774250 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Prosthetics Case Management |
| Taxonomy Definition: | |