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NPI Code Detail

MEDICARE: KRISANNE LENORE HENSLEY CDP

MEDICARE: KRISANNE LENORE HENSLEY CDP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCP60728501WA

General Provider Information

NPI Number : 1639640493
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISANNE LENORE HENSLEY CDP
Provider Business Mailing Address
First Line : 1307 W SPOFFORD AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99205-4354
Country : US
Telephone Number : 509-362-7182
Fax Number : 509-326-3370
Provider Business Practice Location Address
First Line : 3400 W GARLAND AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99205-2119
Country : US
Telephone Number : 509-325-2355
Fax Number : 509-326-3370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2018
Last Update Date : 12/05/2018

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