Provider Demographics
NPI:1326177486
Name:HIRSCH, KANDY R (MA, LMHC, LAC)
Entity Type:Individual
Prefix:
First Name:KANDY
Middle Name:R
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:MA, LMHC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7577 E TRUCES PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3665
Mailing Address - Country:US
Mailing Address - Phone:520-904-3763
Mailing Address - Fax:
Practice Address - Street 1:7577 E TRUCES PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3665
Practice Address - Country:US
Practice Address - Phone:520-904-3763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008769101YM0800X
AZLPC13018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health