Individual
NICHOLE HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCP
Contact information
Practice address
119 E 2ND STREET, THE DALLES, OR 97058
(541) 296-5400
Mailing address
PO BOX 870, BEAVERTON, OR 97075
(541) 296-5400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1928
OR
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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