Individual
EKATERINA HENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
913 GULF BREEZE PKWY STE 26A, GULF BREEZE, FL 32561-4731
(850) 382-1799
Mailing address
913 GULF BREEZE PKWY STE 26A, GULF BREEZE, FL 32561-4731
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH14659
FL
101YM0800X
Mental Health Counselor
MH14659
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH14659
STATE LICENSE
FL
Enumeration date
10/25/2017
Last updated
10/25/2017
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