Provider Demographics
NPI:1417632035
Name:HEINS, MISTY (BA, MATP)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:HEINS
Suffix:
Gender:F
Credentials:BA, MATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 S NUCLA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7316 S NUCLA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1478
Practice Address - Country:US
Practice Address - Phone:720-469-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist