Provider Demographics
NPI:1346065158
Name:KOTVA STRICKLAND, HEIDI JOY (PHD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:JOY
Last Name:KOTVA STRICKLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:961 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2929
Mailing Address - Country:US
Mailing Address - Phone:812-462-4364
Mailing Address - Fax:812-462-4377
Practice Address - Street 1:800 WILDCAT DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IN
Practice Address - Zip Code:47842-7164
Practice Address - Country:US
Practice Address - Phone:812-462-4364
Practice Address - Fax:812-462-4377
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN1577088103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool