Provider Demographics
NPI:1104664127
Name:TWO WINGS THERAPY LLC
Entity type:Organization
Organization Name:TWO WINGS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINISCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:520-333-7682
Mailing Address - Street 1:145 E UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7738
Mailing Address - Country:US
Mailing Address - Phone:520-333-7682
Mailing Address - Fax:
Practice Address - Street 1:145 E UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7738
Practice Address - Country:US
Practice Address - Phone:520-333-7682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty