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General NPI Number Information
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NPI Number | 1144082991
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Entity Type | Individual
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Provider Name | CHRISTINA EILEEN HENCKEN ATR
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Gender | Female
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 326 H STREET CAMP LEJEUNE
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City | JACKSONVILLE
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State | NC
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Zip | 28547-7451
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Country | US
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Telephone | 302-559-8485
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Fax |
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Provider Business Mailing Address
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Address Line | 11300 US HIGHWAY 19 N
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City | CLEARWATER
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State | FL
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Zip | 33764-7451
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Country | US
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Telephone | 302-559-8485
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 22-591
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License Number State | FL
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