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General NPI Number Information
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NPI Number | 1629317573
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Entity Type | Individual
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Provider Name | CYNTHIA ROSE HIERS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 2005 KNIGHT LANE BLDG H MEDICAL STAFF SERVICES
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City | JACKSONVILLE
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State | FL
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Zip | 32212-0140
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Country | US
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Telephone | 843-228-3869
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Fax |
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Provider Business Mailing Address
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Address Line | 670 BOUELVARD DE FRANCE MENTAL HEALTH UNIT
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City | PARRIS ISLAND
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State | SC
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Zip | 29905
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Country | US
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Telephone | 843-228-3869
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 9639
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License Number State | MA
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