Individual
BEVERLY HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/C
Contact information
Practice address
1612 E UNION AVE, FULLERTON, CA 92831-2936
(714) 639-4990
Mailing address
1612 E UNION AVE, FULLERTON, CA 92831-2936
(714) 639-4990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1074989
CA
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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