Individual
KELLY HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
521 E 86TH AVE STE H, MERRILLVILLE, IN 46410-6236
(219) 323-3311
Mailing address
924 N FAIRFIELD AVE # G, CHICAGO, IL 60622-4453
(219) 512-3979
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
05/22/2019
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