Provider Demographics
NPI:1154029700
Name:HEARING TINNITUS BALANCE SOLUTIONS-DIRECT CARE, INC
Entity type:Organization
Organization Name:HEARING TINNITUS BALANCE SOLUTIONS-DIRECT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIIJUANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CANN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:302-722-8193
Mailing Address - Street 1:30661 PEACEFUL LN
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-3485
Mailing Address - Country:US
Mailing Address - Phone:302-722-8193
Mailing Address - Fax:302-674-8521
Practice Address - Street 1:101 WELLNESS WAY STE 300
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4366
Practice Address - Country:US
Practice Address - Phone:302-722-8193
Practice Address - Fax:302-674-8521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech