Healthcare Provider Details

I. General information

NPI: 1881855302
Provider Name (Legal Business Name): GLENNA JEAN HEDRICK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 SPRUCE ST
BELMONT NC
28012-3385
US

IV. Provider business mailing address

1212 SPRUCE ST
BELMONT NC
28012-3385
US

V. Phone/Fax

Practice location:
  • Phone: 704-865-3848
  • Fax: 704-865-3086
Mailing address:
  • Phone: 704-865-3848
  • Fax: 704-854-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5243
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: