Provider Demographics
NPI:1467298422
Name:SOULS TRUE HEALING PSYCHIATRY & WELLNESS, LLC
Entity type:Organization
Organization Name:SOULS TRUE HEALING PSYCHIATRY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GENDREAU
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, APRN- PMHNP-BC
Authorized Official - Phone:401-450-5222
Mailing Address - Street 1:171 WOODLAND CIR
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-2632
Mailing Address - Country:US
Mailing Address - Phone:401-450-5222
Mailing Address - Fax:
Practice Address - Street 1:171 WOODLAND CIR
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-2632
Practice Address - Country:US
Practice Address - Phone:401-450-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty