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Individual

KATHERINE HENDRICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
182 SUNSET AVE NW, COKATO, MN 55321-9620
(763) 689-5385
Mailing address
73127 CSAH 21, DASSEL, MN 55325-3013

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100253
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
273R4HE
BCBS
MN
05
616055700
MN
01
6404177
MEDICA
MN
Enumeration date
09/27/2006
Last updated
07/09/2007
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