Healthcare Provider Details

I. General information

NPI: 1225838618
Provider Name (Legal Business Name): YING QIAN HUANG DAOM, LAC, DIPLOM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W CENTER ST
HOLLY SPRINGS NC
27540-5902
US

IV. Provider business mailing address

2347 IRIS DR
HAW RIVER NC
27258-9712
US

V. Phone/Fax

Practice location:
  • Phone: 919-481-6777
  • Fax:
Mailing address:
  • Phone: 787-238-4803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberLAC-2281
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: