Individual
LISA RENEE HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
107 WOODBRIDGE DR, NEWPORT NEWS, VA 23608-8211
(757) 232-4366
Mailing address
107 WOODBRIDGE DR, NEWPORT NEWS, VA 23608
(757) 232-4366
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000873
VA
Other
Enumeration date
02/08/2013
Last updated
02/08/2013
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