| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DAYTONA HEDRICK | 1508697541 | 2024-11-10 |
Daytona Hedrick is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1508697541. Registration indicates Daytona Hedrick is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Daytona Hedrick CT |
| Practice Office Address | 4200 MUNSON ST NW STE A CANTON, OH US |
| Practice Office Telephone | 3309152907 |
| Practice Office Fax | 3309152958 |
| Mailing Address | 4522 FULTON DR NW CANTON, OH 447182332 US |
| Business Telephone | 3309152907 |
| Business Fax | 3309152958 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 4522 Fulton Dr NW | Canton, OH 447182332 | 3309152907 / 3309152958 |
| Code | Practice | License No State |
|---|---|---|
| 101Y00000X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor Behavioral Health/Substance Abuse/Psychiatry Counselor Behavioral Health & Social Service Providers | C.2405976-TRNE
OH |
| 0073935 | MEDICAID | OH |