Individual
KIRSTEN PAULINE HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2538 BIG HORN AVE, CODY, WY 82414-9299
(307) 587-3219
(307) 527-6218
Mailing address
2538 BIG HORN AVE, CODY, WY 82414-9299
(307) 587-3219
(307) 527-6218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC1527
AZ
101YP2500X
Professional Counselor
Primary
LPC10414
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
734766
AHCCCS
AZ
Enumeration date
05/22/2006
Last updated
06/04/2013
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