Provider Demographics
NPI:1548377062
Name:HIETT, CINDY LEE (MFT)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:LEE
Last Name:HIETT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3086
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96093-3086
Mailing Address - Country:US
Mailing Address - Phone:530-623-4994
Mailing Address - Fax:530-623-4034
Practice Address - Street 1:103 UNION ST
Practice Address - Street 2:DOWNSTAIRS
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093
Practice Address - Country:US
Practice Address - Phone:530-623-4994
Practice Address - Fax:530-623-4034
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35318106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist