Provider Demographics
NPI:1023230430
Name:HAYDEN, KATHERINE HICKMAN (PT, MHA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:HICKMAN
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:PT, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17333 E BELL RD
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-3723
Mailing Address - Country:US
Mailing Address - Phone:985-747-9193
Mailing Address - Fax:
Practice Address - Street 1:17333 E BELL RD
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-3723
Practice Address - Country:US
Practice Address - Phone:985-747-9193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist