Provider Demographics
NPI:1679926950
Name:FRUITS, CINDY HATFIELD (PSY D, LPC)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:HATFIELD
Last Name:FRUITS
Suffix:
Gender:F
Credentials:PSY D, LPC
Other - Prefix:DR
Other - First Name:CINDY
Other - Middle Name:LEA
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY D, LPC
Mailing Address - Street 1:4839 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101
Mailing Address - Country:US
Mailing Address - Phone:770-547-2070
Mailing Address - Fax:770-485-9228
Practice Address - Street 1:4839 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101
Practice Address - Country:US
Practice Address - Phone:770-547-2070
Practice Address - Fax:770-485-9228
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008884103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist