Individual
DR. SUSAN M HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
7600 PARKLAWN AVE STE 415, EDINA, MN 55435-5129
(612) 845-8768
Mailing address
7600 PARKLAWN AVE STE 415, EDINA, MN 55435-5129
(612) 845-8768
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4455
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
404K4HE
BLUE CROSS BLUE SHIELD MN
MN
01
—
937451500
MN HEALTH CARE PROGRAMS
MN
Enumeration date
11/02/2006
Last updated
01/10/2024
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