Individual
KATHLEEN MCCANN DEIDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
100 E IDAHO ST, STE 200, BOISE, ID 83712-6267
(208) 381-5000
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2003023860
MO
103TC0700X
Clinical Psychologist
Primary
PSY202777
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205814
BLUE SHIELD/BLUE CHOICE
MO
05
—
491287009
—
MO
01
—
740169
HEALTHLINK
MO
Enumeration date
05/28/2006
Last updated
02/21/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us