MICAH SHANE HENDRICKSON

AVON PARK, FL
NPI1063887164
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: FL  MH13683)
Enumeration Date2015-12-01
Last Update Date2015-12-01
Business Address
Mr. MICAH SHANE HENDRICKSON MA
2523 US HIGHWAY 27 S STE 130
AVON PARK, FL 33825-7744
Phone number: 863-452-0710
Mailing Address
Mr. MICAH SHANE HENDRICKSON MA
2523 US HIGHWAY 27 S STE 130
AVON PARK, FL 33825-7744
Phone number: 863-452-0710
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