Provider Demographics
NPI:1003001348
Name:MEYER-HEINZMAN, CHRISTY NOEL (MFT INTERN ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:NOEL
Last Name:MEYER-HEINZMAN
Suffix:
Gender:F
Credentials:MFT INTERN ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11104 ROARING FORK ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-2077
Mailing Address - Country:US
Mailing Address - Phone:949-705-9259
Mailing Address - Fax:
Practice Address - Street 1:220 10TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3832
Practice Address - Country:US
Practice Address - Phone:208-468-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health