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General NPI Number Information
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NPI Number | 1154029700
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Entity Type | Organization
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Legal Business Name | HEARING TINNITUS BALANCE SOLUTIONS-DIRECT CARE, INC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 101 WELLNESS WAY STE 300
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City | MILFORD
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State | DE
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Zip | 19963-4366
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Country | US
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Telephone | 302-722-8193
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Fax | 302-674-8521
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Provider Business Mailing Address
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Address Line | 30661 PEACEFUL LN
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City | OCEAN VIEW
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State | DE
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Zip | 19970-3485
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Country | US
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Telephone | 302-722-8193
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Fax | 302-674-8521
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | MRS. KIIJUANA L CANN
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Credential | AU.D
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Telephone | 302-722-8193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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