Individual
KATHY HEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
Mailing address
200 E PARKER LN APT A, LEXINGTON, NC 27292-4196
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24950
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24950
NCSAPPB
NC
Enumeration date
02/21/2019
Last updated
06/22/2021
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