Individual
PHILIP HENNEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, QMHP
Contact information
Practice address
1802 N. LAURENT, VICTORIA, TX 77901
(361) 893-8734
(361) 894-8735
Mailing address
1802 N. LAURENT, SUITE 107, VICTORIA, TX 77901
(361) 893-8734
(361) 894-8735
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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