| Organization Name: | HIGH PRAISE HAIR BOUTIQUE |
| NPI Number: | 1023497054 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ADERINA MICHELLE LEE (OWNER) |
| Mailing Address: | 139 Edgewood Drive North Augusta |
| State: | SC US |
| Postal Code: | 29841 |
| Phone Number: | 8032780605 |
| Fax Number: | 8032781081 |
| NPI Enumeration Date: | 05/22/2015 |
| NPI Last Update Date: | 05/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744P3200X |
| License Number: | 61556 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Prosthetics Case Management |
| Taxonomy Definition: | |