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NPI Code Detail

MEDICARE: LORRIE L. HEDRICK CDCAII

MEDICARE: LORRIE L. HEDRICK CDCAII
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor173227OH

General Provider Information

NPI Number : 1528687589
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRIE L. HEDRICK CDCAII
Provider Business Mailing Address
First Line : 475 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1501
Country : US
Telephone Number : 419-419-5705
Fax Number : 419-775-1254
Provider Business Practice Location Address
First Line : 475 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1501
Country : US
Telephone Number : 419-419-5705
Fax Number : 419-775-1254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 08/27/2020

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