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NPI Code Detail

MEDICARE: KELSEY HENDRIX

MEDICARE: KELSEY HENDRIX
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1962268714
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY HENDRIX
Provider Business Mailing Address
First Line : 1719 N ATLANTIC ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-4804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1719 N ATLANTIC ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-4804
Country : US
Telephone Number : 800-781-5536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2024
Last Update Date : 02/27/2024

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Directions to “ KELSEY HENDRIX ” Practice Location

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