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General NPI Number Information
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NPI Number | 1942585823
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Entity Type | Individual
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Provider Name | THERESA M HINTZE PSYD, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1615 MAPLE LANE
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City | ASHLAND
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State | WI
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Zip | 54806-3626
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Country | US
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Telephone | 715-685-5500
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Fax | 715-682-4022
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Provider Business Mailing Address
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Address Line | 1615 MAPLE LANE
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City | ASHLAND
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State | WI
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Zip | 54806-3626
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Country | US
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Telephone | 715-685-5500
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Fax | 715-682-4022
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1142-226
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3378-57
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5384-125
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License Number State | WI
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