Individual
JACQUELINE HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4525 DEAN MARTIN DR UNIT 501, LAS VEGAS, NV 89103-8107
(904) 504-7234
Mailing address
4525 DEAN MARTIN DR UNIT 501, LAS VEGAS, NV 89103-8107
(904) 504-7234
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
251268
FL
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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