Individual
MICHELLE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11204 WAPLES MILL RD, FAIRFAX, VA 22030-6036
(703) 218-2913
Mailing address
11204 WAPLES MILL RD, FAIRFAX, VA 22030-6036
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810006292
VA
Other
Enumeration date
05/03/2016
Last updated
10/09/2019
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