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General NPI Number Information
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NPI Number | 1265257521
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Entity Type | Organization
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Legal Business Name | KENDRA R HENRY LLC
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 2212 2ND ST SW UNIT 1
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City | ROCHESTER
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State | MN
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Zip | 55902-4421
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Country | US
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Telephone | 507-258-4458
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Fax | 507-899-9577
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Provider Business Mailing Address
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Address Line | 2212 2ND ST SW UNIT 1
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City | ROCHESTER
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State | MN
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Zip | 55902-4421
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Country | US
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Telephone | 507-258-4458
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Fax | 507-899-9577
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Authorized Official
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Title or Position | OWNER
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Name | KENDRA RUTH HENRY
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Credential | LPC
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Telephone | 507-358-8678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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