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General NPI Number Information
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NPI Number | 1053191262
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Entity Type | Individual
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Provider Name | KRISTY LEE HENINGER-DAY CADC-I
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Gender | Female
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 1489 W LACEY BLVD STE 105
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City | HANFORD
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State | CA
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Zip | 93230-5957
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Country | US
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Telephone | 559-978-7803
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Fax |
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Provider Business Mailing Address
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Address Line | 240 N 12TH AVE SUITE #109 BX 324
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City | HANFORD
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State | CA
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Zip | 93230
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Country | US
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Telephone | 559-309-3405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CI139730823
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License Number State | CA
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