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General NPI Number Information
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NPI Number | 1295696326
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Entity Type | Individual
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Provider Name | MATTHEW HIESTAND
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Gender |
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 4287 W PASADENA AVE
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City | FLINT
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State | MI
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Zip | 48504-2342
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Country | US
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Telephone | 303-214-1126
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Fax |
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Provider Business Mailing Address
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Address Line | 2560 BUSINESS PKWY STE A
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City | MINDEN
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State | NV
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Zip | 89423-8961
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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