Provider Demographics
NPI:1811510480
Name:HEIN, KAITLIN MARIKA
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:MARIKA
Last Name:HEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N GILBERT RD STE 204
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-4724
Mailing Address - Country:US
Mailing Address - Phone:480-477-3203
Mailing Address - Fax:
Practice Address - Street 1:625 N GILBERT RD STE 204
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4724
Practice Address - Country:US
Practice Address - Phone:480-477-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor