Individual
MR. V CHRISTIAN HEDEGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2201 RIDGEWOOD RD STE 400, WYOMISSING, PA 19610-1193
(610) 378-9601
(610) 378-9061
Mailing address
207 CEDAR RUN DR, DOUGLASSVILLE, PA 19518-8707
(610) 468-4331
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS-006263-L
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS-006263-L
PA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS-006263-L
PA
103TH0004X
Health Psychologist
PS-006263-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009647800007
—
PA
01
—
11260858
CAQH
—
01
—
PS-006263-L
LICENSED PSYCHOLOGIST
PA
Enumeration date
08/23/2005
Last updated
01/23/2025
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