Individual
THEODORE ROBERT HIDDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
13968 CYPRESS DR STE 1A, BAXTER, MN 56425
(218) 454-1082
Mailing address
13968 CYPRESS DR STE 1A, BAXTER, MN 56425-5904
(218) 454-1082
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1742
MN
Other
Enumeration date
02/02/2018
Last updated
06/06/2018
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