Individual
KAITLYN ANNE HENECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2222 MARTIN LUTHER KING JR BLVD, EUGENE, OR 97401-2475
(541) 224-6987
Mailing address
4579 SOUZA CT, EUGENE, OR 97402-1259
(208) 317-5480
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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