Provider Demographics
NPI:1811190762
Name:HEDIN, ERIC C (M ED)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:HEDIN
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-283-1614
Mailing Address - Fax:603-357-6875
Practice Address - Street 1:15 BRADFORD RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-283-1614
Practice Address - Fax:603-357-6875
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health