| NPI | 1801096573 |
|---|---|
| Former Name | EMMA LAVERNE HENDRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A3190) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2017-01-26 |