| Organization Name: | MICHELLE SALON OF CUTS AND STYLES/ HAIR LOSS CENTER |
| NPI Number: | 1215308135 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE TARANGO (OWNER/ HAIR LOSS SPECIALIST) |
| Mailing Address: | 22243 County Road 374 Gladewater |
| State: | TX US |
| Postal Code: | 756479661 |
| Phone Number: | 9038453430 |
| Fax Number: | |
| NPI Enumeration Date: | 10/19/2015 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744P3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Prosthetics Case Management |
| Taxonomy Definition: | |