Provider Demographics
NPI:1699542589
Name:QUEEN TRINIDAD HEALS
Entity type:Organization
Organization Name:QUEEN TRINIDAD HEALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOMATIC SOUND THERIPIST
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DEANNA
Authorized Official - Last Name:TRINIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED
Authorized Official - Phone:281-254-2542
Mailing Address - Street 1:6748 WILLOWBROOK DR APT 4
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1165
Mailing Address - Country:US
Mailing Address - Phone:281-254-2542
Mailing Address - Fax:
Practice Address - Street 1:404 HOPE MILLS RD UNIT 3
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2222
Practice Address - Country:US
Practice Address - Phone:281-254-2542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Single Specialty