Provider Demographics
NPI:1164275186
Name:QUEEN OF HEARTS HEALTH STUDIES, LLC.
Entity Type:Organization
Organization Name:QUEEN OF HEARTS HEALTH STUDIES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:TIESHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CPT, CPI
Authorized Official - Phone:443-501-9175
Mailing Address - Street 1:8837 TRIMBLE WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3914
Mailing Address - Country:US
Mailing Address - Phone:443-501-9175
Mailing Address - Fax:
Practice Address - Street 1:8407 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-4637
Practice Address - Country:US
Practice Address - Phone:443-501-9175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory ManagementGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty