Provider Demographics
NPI:1386409076
Name:HIETT, CLAIRE KATHRYN
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:KATHRYN
Last Name:HIETT
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 1:3375 VALLEY HILL RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-3231
Mailing Address - Country:US
Mailing Address - Phone:404-213-0687
Mailing Address - Fax:
Practice Address - Street 1:2001 INDIAN DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-3877
Practice Address - Country:US
Practice Address - Phone:706-864-6186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0046362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer