Individual
THEODORE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
43 ROBERT LN, FAIRFIELD, CT 06824-2918
(203) 209-2180
Mailing address
43 ROBERT LN, FAIRFIELD, CT 06824-2918
(203) 209-2180
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
102729
CT
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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