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Individual

MRS. DEBORAH C HADDOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LP, LPC

Contact information

Practice address
4005 W 65TH ST, SUITE 214, EDINA, MN 55435-1720
(612) 940-0653
Mailing address
4005 W 65TH ST, SUITE 214, EDINA, MN 55435-1720
(612) 940-0653

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC00151
MN
103TC1900X
Counseling Psychologist
LP3466
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01H70HA
BCBS ID
MN
01
62-90979
MEDICA ID
MN
01
84905701132
PREFERRED ONE ID
MN
Enumeration date
11/06/2006
Last updated
09/11/2025
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