Kelly Rae Hendricks

NPI #1932858263 in Wautoma, Wisconsin

Provider Information

NPI Number: 1932858263
Entity Type: Individual
Name: Kelly Rae Hendricks
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Mar 23, 2022
Last Updated: Mar 23, 2022

Practice Location

Address: 230 PARK ST
City: Wautoma
State: Wisconsin
ZIP Code: 54982-9031
Phone: (920) 787-6550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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