MEDICARE: MRS. CHRISTEN DAWN HENDRICKS M.S.

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
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1932485612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTEN DAWN HENDRICKS M.S.

Provider Business Mailing Address
First Line	:	9349 WILDCAT SPRINGS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-5708
Country	:	US
Telephone Number	:	702-813-4830
Fax Number	:	702-462-9624

Provider Business Practice Location Address
First Line	:	9349 WILDCAT SPRINGS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-5708
Country	:	US
Telephone Number	:	702-813-4830
Fax Number	:	702-462-9624

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2011
Last Update Date	:	10/26/2011

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