Provider Demographics
NPI:1760030563
Name:NADOBNY, HEDI LYNN (CTRS)
Entity Type:Individual
Prefix:MS
First Name:HEDI
Middle Name:LYNN
Last Name:NADOBNY
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 ASHMAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4449
Mailing Address - Country:US
Mailing Address - Phone:989-374-5014
Mailing Address - Fax:734-893-3156
Practice Address - Street 1:2707 ASHMAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4449
Practice Address - Country:US
Practice Address - Phone:989-374-5014
Practice Address - Fax:734-893-3156
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51734225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist