Provider Demographics
NPI:1033222559
Name:VIETMEIER, CYNTHIA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARIE
Last Name:VIETMEIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ZALABAK RD
Mailing Address - Street 2:
Mailing Address - City:HAWK POINT
Mailing Address - State:MO
Mailing Address - Zip Code:63349-1902
Mailing Address - Country:US
Mailing Address - Phone:636-338-4374
Mailing Address - Fax:636-338-4731
Practice Address - Street 1:155 ZALABAK RD
Practice Address - Street 2:
Practice Address - City:HAWK POINT
Practice Address - State:MO
Practice Address - Zip Code:63349-1902
Practice Address - Country:US
Practice Address - Phone:636-338-4374
Practice Address - Fax:636-338-4731
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030150671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical