Provider Demographics
NPI:1164869574
Name:HEDEGAARD, ANNA K
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:K
Last Name:HEDEGAARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 EL BRIO CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3603
Mailing Address - Country:US
Mailing Address - Phone:702-321-0339
Mailing Address - Fax:
Practice Address - Street 1:2411 EL BRIO CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-3603
Practice Address - Country:US
Practice Address - Phone:702-321-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation