Provider Demographics
NPI:1770975419
Name:HEITZMAN, KRISTINA (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:HEITZMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 MARBLE COVE LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-5820
Mailing Address - Country:US
Mailing Address - Phone:702-349-4822
Mailing Address - Fax:
Practice Address - Street 1:101 S LOCUST ST STE 602
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-6159
Practice Address - Country:US
Practice Address - Phone:972-348-0194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0622106H00000X
TX204615106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist