Doctor Name: | KRISTYN HEINS |
NPI Number: | 1104219260 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 6401014126 |
Business Practice Address: | 11 N Maple St Grant, MI - 493277900 |
Business Phone Number: | 2318340444 |
Business Fax Number: | 2318340200 |
Mailing Address: | 1615 Michigan Ave, BALDWIN |
State: | MI |
Postal Code: | 493047984 |
Phone Number: | 2317455045 |
Fax Number: | 2317455031 |
NPI Enumeration Date: | 03/13/2015 |
NPI Last Update Date: | 03/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401014126 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |