Provider Demographics
NPI:1043792153
Name:HEDRICK, ERICA DANIELLE I (MS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:DANIELLE
Last Name:HEDRICK
Suffix:I
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TRAFALGAR SQ
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-9515
Mailing Address - Country:US
Mailing Address - Phone:317-412-9190
Mailing Address - Fax:
Practice Address - Street 1:14 TRAFALGAR SQ
Practice Address - Street 2:
Practice Address - City:TRAFALGAR
Practice Address - State:IN
Practice Address - Zip Code:46181-9515
Practice Address - Country:US
Practice Address - Phone:317-412-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program