Individual
SHELLY NOREEN HENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP, NCAC-I
Contact information
Practice address
2821 MISSION HILL RD, TULALIP, WA 98271-9706
(360) 716-4323
(360) 651-4404
Mailing address
2821 MISSION HILL RD, TULALIP, WA 98271-9706
(360) 716-4323
(360) 651-4404
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006202
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP00006202
DEPARTMENT OF HEALTH
WA
Enumeration date
10/17/2008
Last updated
10/17/2008
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