Ethan Hendricks

NPI #1902346653 in Provo, Utah

Provider Information

NPI Number: 1902346653
Entity Type: Individual
Name: Ethan Hendricks
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Feb 28, 2017
Last Updated: Feb 28, 2017

Practice Location

Address: 750 N FREEDOM BLVD
City: Provo
State: Utah
ZIP Code: 84601-1677
Phone: (801) 373-4760

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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