Provider Demographics
NPI:1194458307
Name:HINES, CHIQUITA BRITT (LMBT)
Entity type:Individual
Prefix:
First Name:CHIQUITA
Middle Name:BRITT
Last Name:HINES
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 SUMTER DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8647
Mailing Address - Country:US
Mailing Address - Phone:919-879-7869
Mailing Address - Fax:
Practice Address - Street 1:2355 SUMTER DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8647
Practice Address - Country:US
Practice Address - Phone:919-879-7869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20388225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist