Doctor Name: | MARY HEINTZ |
NPI Number: | 1508910670 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC |
License Number: | 100 |
Business Practice Address: | 125 2nd Street Ste F Monument, CO - 80132 |
Business Phone Number: | 7193867480 |
Business Fax Number: | |
Mailing Address: | Po Box 1928, MONUMENT |
State: | CO |
Postal Code: | 801321928 |
Phone Number: | 7193867480 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |