Individual
MS. JILL HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S.,LPC
Contact information
Practice address
106 MISTY HOLLOW DR, CARROLLTON, GA 30116-8803
(770) 880-0233
Mailing address
106 MISTY HOLLOW DR, CARROLLTON, GA 30116-8803
(770) 880-0233
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006290
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC006290
LICENSED PROFESSIONAL COUNSELOR
GA
Enumeration date
02/02/2023
Last updated
02/02/2023
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