Healthcare Provider Details

I. General information

NPI: 1346364551
Provider Name (Legal Business Name): KARA M. HENDRY,PSY.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5348 1ST AVE N
ST PETERSBURG FL
33710-8106
US

IV. Provider business mailing address

PO BOX 47918
ST PETERSBURG FL
33743-7918
US

V. Phone/Fax

Practice location:
  • Phone: 727-322-6123
  • Fax: 727-322-6143
Mailing address:
  • Phone: 727-322-6123
  • Fax: 727-322-6143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY6690
License Number StateFL

VIII. Authorized Official

Name: DR. KARA MATILE HENDRY
Title or Position: PRESIDENT
Credential: PSY.D., P.A.
Phone: 727-322-6123