Provider Demographics
NPI:1750446027
Name:HEDDING, THOMAS A (PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:HEDDING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 SHOAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8677
Mailing Address - Country:US
Mailing Address - Phone:336-664-0666
Mailing Address - Fax:
Practice Address - Street 1:431 SPRING GARDEN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6564
Practice Address - Country:US
Practice Address - Phone:336-854-4450
Practice Address - Fax:336-235-2183
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1857103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling