| NPI | 1770009854 |
|---|---|
| Former Name | KATHLEEN VICTORIA HENDRICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-8421) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-23176) |
| 101YP2500X Counselor, Professional (Licence: CO 0014263) | |
| Enumeration Date | 2017-08-20 |
| Last Update Date | 2023-12-11 |