Provider Demographics
NPI:1669485934
Name:HIDEG, JULIE K (PSYD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:HIDEG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 KENTUCKY AVE
Mailing Address - Street 2:PSYCHOLOGICAL ASSOCIATES OF PADUCAH
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3242
Mailing Address - Country:US
Mailing Address - Phone:270-442-8785
Mailing Address - Fax:270-443-1784
Practice Address - Street 1:2204 KENTUCKY AVE
Practice Address - Street 2:PSYCHOLOGICAL ASSOCIATES OF PADUCAH
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3242
Practice Address - Country:US
Practice Address - Phone:270-442-8785
Practice Address - Fax:270-443-1784
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1317103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0644077Medicare ID - Type Unspecified
KYP75556Medicare UPIN