Deidrick, Kathleen Mccann
Deidrick, Kathleen Mccann is an individual health care provider with primary practice located at 100 E Idaho St Ste 200, Boise ID 83712-6267. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Deidrick, Kathleen Mccann can be contacted via phone (208) 381-5000.Contact Information
Primary practice address
100 E Idaho St Ste 200
Boise ID 83712-6267
Phone: (208) 381-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2003023860 | Missouri |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY202777 | Idaho |
Profile Details
| NPI number | 1891742540 |
|---|---|
| LBN Legal business name | Deidrick, Kathleen Mccann |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 28th, 2006 |
| Last updated | Feb 21st, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891742540 | NPPES |
| Missouri | Other | 740169 | HEALTHLINK |
| Missouri | Other | 205814 | HEALTHLINK |
| Missouri | MEDICAID | 491287009 | HEALTHLINK |
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