Individual
MICHELENA ANNETTE RILES HENDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
690 N REILLY RD, FAYETTEVILLE, NC 28303-5724
(910) 987-0469
Mailing address
232 TIVERTON STREET, FAYETTEVILLE, NC 28314
(910) 849-8619
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588068886
MEDICARE
—
Enumeration date
10/15/2014
Last updated
12/23/2018
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