Provider Demographics
NPI:1801969183
Name:HEDICAN, KATHRYN HOPE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:HOPE
Last Name:HEDICAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:HOPE
Other - Last Name:VANDERLOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2925
Mailing Address - Country:US
Mailing Address - Phone:319-352-2064
Mailing Address - Fax:319-352-2329
Practice Address - Street 1:111 10TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2925
Practice Address - Country:US
Practice Address - Phone:319-352-2064
Practice Address - Fax:319-352-2329
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health