Provider Demographics
NPI:1497643092
Name:SHE BY SHERAY WIGS
Entity type:Organization
Organization Name:SHE BY SHERAY WIGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-742-9430
Mailing Address - Street 1:43996 WOODWARD AVENUE
Mailing Address - Street 2:STE 5 #2053
Mailing Address - City:BLOOMFIELD TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:313-742-9430
Mailing Address - Fax:
Practice Address - Street 1:135 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1934
Practice Address - Country:US
Practice Address - Phone:313-742-9430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier