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General NPI Number Information
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NPI Number | 1629479951
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Entity Type | Individual
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Provider Name | AMY HENDRICKS LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2014
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 417 REIGERTS LN
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City | ANNVILLE
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State | PA
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Zip | 17003-2120
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Country | US
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Telephone | 717-867-8335
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Fax |
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Provider Business Mailing Address
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Address Line | 265 FARMHOUSE LN
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City | PALMYRA
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State | PA
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Zip | 17078-8706
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Country | US
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Telephone | 717-576-2868
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000767
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License Number State | PA
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