Individual
KATELYN R HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
270 SPARTA AVE, SPARTA, NJ 07871-1122
(570) 351-5001
Mailing address
110 BALD HILL TER, MILFORD, PA 18337-4024
(570) 832-3212
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12369696
CO
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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