Individual
EDD DOUGLAS EASTON-HOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
246 E MAIN ST, BEATTYVILLE, KY 41311-9369
(606) 464-3611
Mailing address
210 N BROADWAY ST STE 5, BEREA, KY 40403-2212
(859) 779-0616
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
130240
KY
103TC0700X
Clinical Psychologist
Primary
130240
KY
103TC0700X
Clinical Psychologist
KY-1778
KY
Other
Enumeration date
09/22/2009
Last updated
03/20/2024
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