| NPI | 1548675390 |
|---|---|
| Former Name | SHEILA RAE HENDRICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0011614) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001162) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2019-05-31 |